Efficacy of X-ray stereotactic radiotherapy on brain metastases and prognostic analysis
- VernacularTitle:脑转移瘤X线立体定向放射治疗的疗效及影响因素
- Author:
Wei WEI
1
;
Deng MEI-LING
;
Wu SHAO-XIONG
;
Zeng ZHI-FAN
;
Li FENG-YAN
;
Wang HAN-YU
;
Bao YONG
;
Gao YUAN-HONG
;
Chen LI-XIN
Author Information
1. 中山大学肿瘤防治中心
- Keywords:
Brain metastasis;
effect;
prognostic;
stereotactic radiotherapy
- From:Chinese Journal of Cancer
2010;29(2):217-222
- CountryChina
- Language:Chinese
-
Abstract:
Background and Objective:X-ray stereotactic radiotherapy(SRT) is one of the effective treatments for brain metastases(BM).This study was to evaluate the efficacy of SRT on BM, and investigate prognostic factors. Methods:Between July 1999 and December 2004,a total of 122 intracranial lesions in 78 patients with BM were treated using SRT in our center.Fortynine patients had a solitary lesion and 29 had multiple(2-6)lesions.Themedian SRT dose was 15 Gy(11-24 Gy)in single fraction for 38 lesions,and 24 Gy(11-40 Gy)in 2-6 fractions for 84 lesions.SRT was combinedwith whole brain radiotherapy (WBRT) of 30-40 Gy for 39 patients.Progression-free survival(PFS)and overall survival(OS)were estimated by Kaplan.Meier method. Univariate and multivariate analyses were pedormedby the log-rank test and Cox model, respectively. Results:The mediansurvival time was 12.9 months(1.7-77.4 months).The 1-year intracranialPFS rate was 87.4%.The 1.and 2-year OS rates were 53.9%and 25.8%, respectively. Univariate analysis showed that the 1-year OS rates were significantly higher in the patients with pretreatment KPS of≥ 70,extracranial lesions controlled and SRT combined with WBRT than in those with KPS of<70 (60.7%vs. 29.4%,P=0.002), extracranial lesions uncontrolled (69%MS.44.9%, P=0.005) and SRT alone(64.1%vs.43.4%.P=0.03).The benefit of treating with WBRT in combination was mainly achieved in Patients with extracranial lesions controlled or with more than one intracranial lesion.Multivariate analysis showed that KPS score and status of extracranial Iesions were independent prognostic factors for OS.Conclusions: SRT is an effective and safe modality for BM. SRT combined with WBRT may prolong the survival time for patients with extracranial lesions controlled or multiple intracranial lesions. Independent prognostic factors for OS are KPS score and status of extracranial lesions.
