JAMA ONCOL:放疗和手术治疗对脑转移瘤局部控制的影响

2018-11-11 MedSci MedSci原创

脑转移是肿瘤患者常见的合并症,脑转移的局部治疗应选择手术切除还是立体定向放疗(SRS)尚缺乏足够的证据。JAMA ONCOL近期发表了一篇文章,比较SRS与手术切除治疗患者脑转移的局部控制情况。

脑转移是肿瘤患者常见的合并症,脑转移的局部治疗应选择手术切除还是立体定向放疗(SRS)尚缺乏足够的证据。JAMA ONCOL近期发表了一篇文章,比较SRS与手术切除治疗患者脑转移的局部控制情况。

作者对EORTC 22952-26001临床试验的数据进行了二次分析。分析时对患者进行了分层,但但未随机化。研究的主要终点是治疗区域的局部复发情况。根据不同情况(手术切除与SRS)计算局部复发的累积发生率。研究共纳入268例患者(男性66.4%;中位年龄60.7岁); 154例患者(57.5%)接受了SRS,114例患者(42.5%)接受了手术切除。中位随访时间为39.9个月。与SRS组相比,接受手术切除的患者转移灶较大,1处脑转移更常见,且脑转移位置不同。在调整后的模型中,SRS和手术切除组之间的局部复发情况相似。但是,当按时间间隔分层后,手术切除的患者与接受SRS的患者相比,早期(0-3个月)局部复发的风险更高,但随着时间增加风险降低。在9个月及以后,手术切除组的局部复发风险较低。

文章最后认为,SRS与手术切除的脑转移局部控制情况相似。与手术切除相比,SRS与接受治疗病灶的早期局部控制改善相关。

原始出处:

Thomas M. Churilla, Imran H. Chowdhury, et al. Comparison of Local Control of Brain Metastases With Stereotactic Radiosurgery vs Surgical Resection A Secondary Analysis of a Randomized Clinical Trial. JAMA Oncol. November 8 2018 doi: 10.1001/jamaoncol.2018.4610

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    2019-07-09 minlingfeng
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    2018-11-13 chg122

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