Survival benefit of stereotactic radiosurgery for metastatic brain tumors in patients with controlled primary lesions and no other distant metastases.
Survival benefit of stereotactic radiosurgery for metastatic brain tumors in patients with controlled primary lesions and no other distant metastases.
复制标题
立体定向放射外科治疗原发灶受控且无其他远处转移的转移性脑肿瘤患者的生存获益。
作者：
Y. Niibe;K. Karasawa;O. Nakamura;N. Shinoura;K. Okamoto;Ryouji Yamada;Kouichi Fukino;Yoshiaki Tanaka
迄今为止，转移性脑肿瘤患者的预后非常差，因为大多数转移性脑肿瘤患者存在其他转移病灶和/或活动性原发灶。而且，如果不存在活动性病灶，常规放射治疗的局部控制效果不佳，这也导致预后不良。因此，我们进行了当前的研究，研究原发灶受控且无其他远处转移的患者接受立体定向放射外科（SRS）（一种局部控制的转移性脑肿瘤的优越方法）治疗的患者是否存在生存获益。 1999 年 8 月至 2001 年 8 月期间，日本东京都立驹込医院对 77 名患有 90 个转移性脑肿瘤的患者进行了 SRS 治疗。其中，10名患有17个转移性脑肿瘤的患者的原发灶得到控制，并且当前研究中没有包括其他远处转移。中位规定的等中心剂量为 30 Gy (30-45 Gy)，中位规定的外周剂量为 25 Gy (12-30 Gy)。一年和三年局部控制率分别为90.0%和90.0%。一年和三年总生存率分别为88.9%和51.9%。这些结果表明，SRS治疗转移性脑肿瘤确实对原发灶得到控制且没有其他远处转移的患者具有生存获益，这意味着我们不应该以姑息性的目的来治疗这些患者，而应该追求更长的生存期。
The prognosis of patients with metastatic brain tumors has been very poor so far because most patients with metastatic brain tumors had other metastatic lesions and/or active primary lesions. Moreover, if no active lesions existed, local control of conventional radiation therapy was not so good, which also led to the poor prognosis. Thus, we conducted the current study concerning whether survival benefit existed in patients with controlled primary lesions and no other distant metastases, who were treated with stereotactic radiosurgery (SRS), a superior method for local control, for metastatic brain tumors. Seventy-seven patients with 90 metastatic brain tumors were treated with SRS between August 1999 and August 2001, at Tokyo Metropolitan Komagome Hospital, Japan. Of these, 10 patients with 17 metastatic brain tumors had primary lesions controlled and no other distant metastases were included in the current study. The median prescribed isocenter dose was 30 Gy (30-45 Gy) and the median prescribed peripheral dose was 25 Gy (12-30 Gy). One-year and 3-year local control rates were 90.0% and 90.0%, respectively. One-year and 3-year overall survival rates were 88.9% and 51.9%, respectively. These results suggest that SRS for metastatic brain tumors does have a survival benefit in patients with controlled primary lesions and no other distant metastases, which means that we should not treat these patients with palliative intent but pursue longer survival.