SRT与SRS治疗肺腺癌脑转移瘤对比分析  

A comparative analysis of SRT and SRS in the treatment of brain metastases from lung adenocarcinoma

作　　者：李勇[1] 刘风华 梁康宁 邵显军 张丽[1] 梁晓华 潘绵顺[1] Li Yong;Liu Fenghua;Liang Kangning;Shao Xianjun;Zhang Li;Liang Xiaohua;Pan Mianshun(Center of Radiation Oncology,Shanghai Wujing Hospital,Shanghai 201103,China;Center of Radiation Oncology,The Third Affiliated Hospital of Naval Military Medical University,Shanghai 201805,China;Department of Oncology,Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China)

机构地区：[1]武警上海市总队医院武警部队肿瘤放射诊疗中心,201103 [2]海军军医大学第三附属医院放疗科,上海201805 [3]复旦大学附属华山医院肿瘤科,上海200040

出　　处：《中华放射肿瘤学杂志》2020年第2期88-92,共5页Chinese Journal of Radiation Oncology

基　　金：国家重点研发计划项目(2017YFC0113701);上海市长宁区肿瘤放射诊疗中心特色专科建设项目(20193006)。

摘　　要：目的回顾性分析2006年1月至2016年12月间的肺腺癌脑转移瘤患者治疗疗效并进行相关因素分析。方法多中心回顾性分析肺腺癌脑转移瘤患者208例,其中SRT患者86例,SRS患者122例。分析两组患者的临床特征并比较两组局部肿瘤控制时间、中位生存期及放射性脑损伤情况。结果SRT、SRS的肿瘤客观缓解率分别为70.9%、71.3%,12个月局部肿瘤控制率分别为89%、86%(P=0.383)。全组中位总生存期为14.3个月,其中SRT为15.6个月,SRS为13.7个月(P=0.349)。多因素分析显示患者预后不佳的主要因素为靶区总体积较大(P<0.001)、GPA评分较低(P=0.012)及无敏感基因突变(P<0.001)。SRT、SRS晚期放射性脑损伤发生率分别为5.8%、14.8%(P=0.043)。结论SRT与SRS治疗肺腺癌脑转移瘤疗效相似,SRT可能比SRS有更低的晚期放射性脑损伤发生率。Objective To compare the clinical efficacy of stereotactic radiotherapy(SRT)and stereotactic radiosurgery(SRS)in the treatment of brain metastases from January 2006 to December 2016,lung adenocarcinoma and analyze the related factors.Methods In this multi-center retrospective analysis,clinical data of 208 patients with brain metastases from lung adenocarcinoma were retrospectively analyzed and assigned into the SRT(n=86)and SRS groups(n=122).The clinical characteristics of patients in two groups were analyzed.The local tumor control rate,median survival time and radiation brain injury were statistically compared between two groups.Results At the end of follow-up,the objective response rates(ORR)were 70.9%and 71.3%in the SRT and SRS groups(P=0.772).The local tumor control rates at 12 months were 89%and 86%in the SRT and SRS groups(P=0.383).The median overall survival time of all patients was 14.3 months,15.6 months in the SRT group and 13.7 months in the SRS group(P=0.349).Multivariate analysis showed that large target volume(P<0.001),low GPA score(P=0.012)and no insensitive gene mutation(P<0.001)were the main factors of poor prognosis.The incidence of late radiation brain injury was 5.8%and 14.8%in two groups(P=0.043).Conclusions SRT and SRS yield similar clinical efficacy in the treatment of brain metastases from lung adenocarcinoma.SRT may have a lower incidence of late radiation brain injury than SRS.

关 键 词：脑转移/肺肿瘤 立体定向放射疗法 立体定向放射外科 

分 类 号：R734[医药卫生—肿瘤]