Fractionated stereotactic radiotherapy for metastatic brain tumors that recurred after gamma knife radiosurgery results in acceptable toxicity and favorable local control.
Fractionated stereotactic radiotherapy for metastatic brain tumors that recurred after gamma knife radiosurgery results in acceptable toxicity and favorable local control.
复制标题
伽玛刀放射外科手术后复发的转移性脑肿瘤的分次立体定向放射治疗具有可接受的毒性和良好的局部控制。
DOI：
10.1007/s10147-016-1058-x
复制
发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Hirai T
中科院分区：
文献类型：
--
作者：
Miyakawa A;Shibamoto Y;Takemoto S;Serizawa T;Otsuka S;Hirai T
为了治疗脑转移瘤伽玛刀放射外科手术（GKS）后局部复发，我们使用了分次立体定向放射治疗（SRT）。本研究的目的是评估SRT的疗效和毒性在这些patients.Methods50局部复发转移性脑肿瘤的47例患者进行了SRT治疗。GKS的中位处方剂量为20戈伊。GKS（进行多次GKS手术的病例的最后一次治疗）和复发之间的中位间隔为7.5（范围1-33）个月。根据肿瘤的大小和位置以及先前的GKS剂量，几种剂量分级方案用于SRT。SRT在等中心的中位处方剂量为30戈伊，中位数为10 fractions.ResultsAmong的50个病灶与SRT治疗，26个没有复发局部之前，患者的死亡或最后一次随访检查，和24个局部复发。存活患者的中位随访期为首次GKS手术后24个月，1年总生存率为80%，2年为57%。SRT后局部复发的中位时间（16个月）明显长于末次GKS和复发之间的中位时间间隔（7.5个月;P< 0.001）。只有两名患者发展≥ 2级放射necross.ConclusionsStereotactic放疗复发转移性脑肿瘤是一种有效的治疗方法，并取得了相对较好的局部控制。相关不良事件通常可接受。
BackgroundTo treat local recurrence of brain metastases after gamma knife radiosurgery (GKS), we have used fractionated stereotactic radiotherapy (SRT). The purpose of this study was to evaluate the efficacy and toxicity of SRT in these patients.MethodsFifty locally recurrent metastatic brain tumors in 47 patients were treated with SRT. The median prescribed dose of GKS was 20 Gy at the periphery. The median interval between the GKS (the last session in cases in which multiple GKS procedures were performed) and recurrence was 7.5 (range 1–33) months. Several dose-fractionation protocols were used for SRT, depending on the size and location of the tumor and previous GKS dose. The median prescribed dose of the SRT at the isocenter was 30 Gy with a median of ten fractions.ResultsAmong the 50 lesions treated with SRT, 26 did not recur locally before the patient’s death or the last follow-up examination, and 24 recurred locally. The median follow-up period for the surviving patients was 24 months after the first GKS procedure, and the overall survival rate was 80% at 1 year and 57% at 2 years. The median time to local re-recurrence after the SRT (16 months) was significantly longer than the median interval between the last GKS and recurrence (7.5 months;P< 0.001). Only two patients developed ≥grade 2 radiation necrosis.ConclusionsStereotactic radiotherapy appeared to be an effective treatment for recurrent metastatic brain tumors and yielded relatively good local control. The associated adverse events were generally acceptable.