Stereotactic body radiation therapy (SBRT) in recurrent, persistent or oligometastatic gynecological cancers
Stereotactic body radiation therapy (SBRT) in recurrent, persistent or oligometastatic gynecological cancers
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DOI：
10.1016/j.ygyno.2020.10.001
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发表时间：
2020-12-01
影响因子：
4.7
通讯作者：
Kersh, Charles R.
中科院分区：
文献类型：
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作者：
Reshko, Leonid B.;Baliga, Sujith;Kersh, Charles R.
目标。SBRT是一种耐受性良好的技术，在各种转移和复发的肿瘤类型中提供局部区域控制。SBRT在颅外复发、持续性或少转移的妇科肿瘤中的作用尚未得到很好的研究。因此，我们对这一背景下相当数量的患者进行了回顾性分析。我们对86例患者209个肿瘤进行了回顾性研究，这些肿瘤是在我们医院接受SBRT治疗的复发的、持续性的或少见转移的妇科颅外肿瘤。中位随访时间为20个月(范围1-91个月)。SBRT剂量中位数为24Gy10~50次，中位数4次(1~6次)。采用Kaplan-Meier曲线和对数等级检验评估局部控制率(LC)和总生存率(OS)。使用COX比例风险模型对LC和OS的相关协变量进行评估。1年和3年LC分别为80%和68%。1年和3年OS分别为70%和39%。完全缓解32%，部分缓解23%，病情稳定20%。在较小的肿瘤中，SBRT取得了更好的局部控制。毒性一般较轻，最常见的是1级胃肠道毒性和乏力。只有4.3%的治疗导致2级或更大的毒性。仅1例为3级，无4级或5级毒性。SBRT局部控制率高，毒性发生率低，主要是1级胃肠道毒性和乏力，为骨盆和盆腔外的少转移性骨外肿瘤提供了有效的抢救治疗。(C)2020 Elsevier Inc.保留所有权利。
Objective. SBRT is a well-tolerated technique and provides local-regional control in a variety of metastatic and recurrent tumor types. The role of SBRT in extracranial recurrent, persistent, or oligometastatic gynecological tumors is not well-studied. We therefore retrospectively analyzed a sizeable number of patients in this setting.Methods. We performed a retrospective review of 86 patients with 209 tumors treated at our institution with SBRT for recurrent, persistent, or oligometastatic extracranial gynecological tumors. The median follow-up was 20 months (range 1-91). The median SBRT dose was 24 Gy (range 10-50) delivered in a median of 4 fractions (range 1-6). The Kaplan-Meier curves and log rank tests were used to assess local control (LC) and overall survival (OS). Cox proportional hazards model was used to evaluate for covariates associated with LC and OS.Results. The 1- and 3-year LC were 80% and 68% respectively. The 1- and 3-year OS were 70% and 39%. 32% of the lesions demonstrated complete response, 23% partial response and 20% stable disease. SBRT achieved better local control in smaller tumors. Toxicity was typically mild with grade 1 gastrointestinal toxicity and fatigue being the most common. Only 4.3% of treatments resulted in grade 2 or greater toxicity. There was only one case of grade 3 and no grade 4 or 5 toxicities.Conclusions. SBRT offers a high rate of local control with low incidence of toxicity, mainly grade 1 GI toxicity and fatigue, and provides effective salvage therapy for oligometastatic extracranial pelvic and extra-pelvic gynecological tumors. (C) 2020 Elsevier Inc. All rights reserved.