立体定向放射外科治疗脑转移瘤的五年幸存者:生物学、不断改进的治疗方法,还是纯粹的运气?

IF 2.4 Q2 CLINICAL NEUROLOGY Neuro-oncology practice Pub Date : 2022-12-13 eCollection Date: 2023-04-01 DOI:10.1093/nop/npac095
Jane B Pearce, Fang-Chi Hsu, Claire M Lanier, Christina K Cramer, Jimmy Ruiz, Hui-Wen Lo, Fei Xing, Margaret Smith, Wencheng Li, Christopher Whitlow, Jaclyn J White, Stephen B Tatter, Adrian W Laxton, Michael D Chan
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引用次数: 0

摘要

背景:随着治疗方法的改进,脑转移瘤长期存活者的人数不断增加。本研究比较了脑转移瘤 5 年存活者和全身性脑转移瘤存活者,以评估影响长期存活的因素:方法:对单个机构进行了回顾性审查,以确定接受立体定向放射外科手术(SRS)的脑转移瘤 5 年存活者。结果:共有98名脑转移瘤患者接受了立体定向放射外科手术(SRS)治疗:结果:共发现98名脑转移患者存活超过60个月。在首次接受 SRS 时的年龄(P = .19)、原发癌分布(P = .80)和首次接受 SRS 时的转移灶数量(P = .90)方面,长期幸存者与对照组之间没有发现差异。长期幸存者队列中,6年、8年和10年的神经系统死亡累积发生率分别为4.8%、16%和16%。在历史对照组中,神经系统死亡的累积发生率在 4.9 年后达到 40%的高点。首次接受 SRS 时的疾病负担分布在 5 年期幸存者和对照组之间存在明显差异(P = .0049)。58%的5年生存者在最后一次随访时没有临床疾病的迹象:结论:脑转移瘤五年生存者代表了一个多样化的组织学群体,这表明每种癌症类型都有一小部分寡转移和不活跃癌症患者。
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Five-year survivors from brain metastases treated with stereotactic radiosurgery: Biology, improving treatments, or just plain luck?

Background: Improvements in therapies have led to an increasing number of long-term survivors of brain metastases. The present series compares a population of 5-year survivors of brain metastases to a generalized brain metastases population to assess for factors attributable to long-term survival.

Methods: A single institution retrospective review was performed to identify 5-year survivors of brain metastases who received stereotactic radiosurgery (SRS). A historical control population of 737 patients with brain metastases was used to assess similarities and differences between the long-term survivor population and the general population treated with SRS.

Results: A total of 98 patients with brain metastases were found to have survived over 60 months. No differences between long-term survivors and controls were identified with regards to the age at first SRS (P = .19), primary cancer distribution (P = .80), and the number of metastases at first SRS (P = .90). Cumulative incidence of neurologic death at 6, 8 and 10 years for the long-term survivor cohort was 4.8%, 16%, and 16% respectively. In the historical controls, cumulative incidence of neurologic death reached a plateau at 40% after 4.9 years. A significant difference in the distribution of burden of disease at the time of the first SRS was found between the 5-year survivors and the control (P = .0049). 58% of 5-year survivors showed no evidence of clinical disease at the last follow-up.

Conclusion: Five-year survivors of brain metastases represent a diverse histologic population, suggesting a small population of oligometastatic and indolent cancers exist for each cancer type.

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来源期刊
Neuro-oncology practice
Neuro-oncology practice CLINICAL NEUROLOGY-
CiteScore
5.30
自引率
11.10%
发文量
92
期刊介绍: Neuro-Oncology Practice focuses on the clinical aspects of the subspecialty for practicing clinicians and healthcare specialists from a variety of disciplines including physicians, nurses, physical/occupational therapists, neuropsychologists, and palliative care specialists, who have focused their careers on clinical patient care and who want to apply the latest treatment advances to their practice. These include: Applying new trial results to improve standards of patient care Translating scientific advances such as tumor molecular profiling and advanced imaging into clinical treatment decision making and personalized brain tumor therapies Raising awareness of basic, translational and clinical research in areas of symptom management, survivorship, neurocognitive function, end of life issues and caregiving
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