Radiation boost does not help whole-brain radiotherapy further improve survivals of SCLC brain metastasis patients
10.3760/cma.j.issn.1004-4221.2018.06.003
- VernacularTitle:局部增量照射无益于全脑照射SCLC脑转移患者生存再提高
- Author:
Zhensheng LI
1
;
Dongxing SHEN
;
Xiaofei SHEN
;
Xuejuan DUAN
;
Jun ZHANG
Author Information
1. 河北医科大学第四医院放疗科
- Keywords:
Brain metastasis;
small-cell lung cancer/whole-brain radiotherapy;
Prognosis
- From:
Chinese Journal of Radiation Oncology
2018;27(6):553-558
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of radiation boost ( Boost ) on further improving overall survival ( OS) and intracranial progression-free survival ( IPFS) of small-cell lung cancer ( SCLC) brain metastases (BM) patients treated by whole-brain radiotherapy (WBRT). Methods A retrospective analysis of 142 consecutive SCLC BM patients admitted between 2013 and 2015 was conducted after excluding those with historical prophylactic cranial irradiation (n=16) or SRT (n=10) or local RT alone (n=1).The Kaplan-Meier curve was utilized to calculate the survival rate. The log-rank test and multivariate Cox proportional hazard regression model were utilized to evaluate clinical prognosis. Results All patients were aged 59. 6 years old on average, and the female proportion was 23％. The quantity of brain metastasis lesion was 1 in 35％, 2-3 in 23％ and ≥4 in 42％, respectively. The proportion of patients receiving chemotherapy was 70％. The median OS was 9. 0 months and the median IPFS was 7. 3 months. The accumulative mortality rate in the non-radiation ( n=53 ) , WBRT ( n=33 ) and WBRT+ Boost ( n=56 ) groups was 92％, 79％ and 73％, and the accumulative failure rate ( death or new/relapsed brain metastasis) was 94％, 82％ and 80％, respectively. Compared with the non-radiation group, WBRT and WBRT+Boost therapies exerted significant effect upon OS ( P=0. 000 and 0. 000) and IPFS ( P=0. 000 and 0. 000) . Compared with WBRT alone, WBRT+ Boost treatment exerted no significant effect upon OS ( P=0. 41 and 0. 51) . Conclusions WBRT can significantly improve OS and IPFS of patients with SCLC-BM. However, concurrent and additional radiation boost does not further improve the survival rate.
