Microsurgery vs. radiosurgery for the treatment of multiple metastases in the brain: a retrospective cohort study  

作　　者：Qun Liu Qiang Yin Yang Dong Fengtong Li Wenliang Li Xiaoguang Wang 

机构地区：[1]Department of Neurosurgery and Neuro-Oncology [2]CyberKnife Center,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,Key Laboratory of Cancer Prevention and Therapy,Tianjin,Tianjin’s Clinical Research Center for Cancer,Tianjin 300060,China

出　　处：《Cancer Biology & Medicine》2022年第6期884-892,共9页癌症生物学与医学（英文版）

基　　金：This study was supported by research grants from the Tianjin Municipal Science and Technology Commission(Grant No.18JCYBJC27600).

摘　　要：Objective:Multiple brain metastases are a severe condition for cancer patients.To date,no general consensus exists regarding the optimal treatment procedure for multiple brain metastases.Radiotherapy is the most commonly used treatment option.The role of surgical resection for multiple brain metastases is unclear.The aim of this study was to compare the outcomes of patients with multiple brain metastases treated with either surgery or stereotactic radiosurgery(SRS).Methods:The medical records of 279 consecutive adult patients with multiple brain metastases treated with either surgery(26 patients)or SRS(253 patients)were retrospectively reviewed.Propensity score matching was conducted to correct for discrepancies in the baseline characteristics,and 78 patients(26 receiving surgery and 52 receiving SRS)were chosen for comparison of outcomes,such as overall survival,local tumor control rate,and symptom improvement.Results:The tumor size in the surgery group was significantly greater than that in the SRS group after propensity score matching.However,the neurological recovery rate,incidence of leptomeningeal metastasis after surgery,1-year local tumor control rate,and overall survival were not significantly different between groups.Conclusions:Our data demonstrate that surgery and radiosurgery have identical overall survival and local tumor control rates in patients with 2 to 4 brain metastases.Although SRS remains the primary and standard option for patients with brain metastasis,surgery offers several distinct advantages,such as establishing a diagnosis or relieving mass effects,and may additionally be beneficial in carefully selected patients with 2–4 brain metastases.

关 键 词：SURGERY RADIOSURGERY brain metastasis THERAPY overall survival 

分 类 号：R739.41[医药卫生—肿瘤]