CAJ | 학술논문

目的评价小细胞肺癌( SCLC)全脑放疗(WBRT)后颅内失败分次立体定向放疗(FSRT)挽救的价值.方法回顾分析WBRT失败后使用FSRT挽救的35例SCLC脑转移患者的生存情况,多因素分析确定和生存相关的预后因素.结果随访率为100％,中位随访时间11个月.全组总中位生存期为10.3个月,多因素分析显示颅外疾病控制状态和患者的生存相关(χ2=4.02,P=0.045).自诊断脑转移开始中位生存期为22.0个月,未发现严重晚期不良反应.6、12个月局部控制率分别为91％、76％.6例局部未控患者中3例行二程FSRT挽救,挽救治疗后生存时间分别为3、9、13个月.6例患者FSRT后出现治疗野外新病灶,出现新病灶中位时间为4个月.32例患者死亡,其中14例死于颅内进展,14例死于颅外疾病进展,1例死于脑脊髓膜广泛转移,3例死于其他原因(2例肺部感染,1例死因不明).结论 FSRT挽救治疗对WBRT后复发SCLC脑转移安全有效.
목적 평개소세포폐암( SCLC)전뇌방료(WBRT)후로내실패분차입체정향방료(FSRT)만구적개치.방법 회고분석WBRT실패후사용FSRT만구적35례SCLC뇌전이환자적생존정황,다인소분석학정화생존상관적예후인소.결과 수방솔위100％,중위수방시간11개월.전조총중위생존기위10.3개월,다인소분석현시로외질병공제상태화환자적생존상관(χ2=4.02,P=0.045).자진단뇌전이개시중위생존기위22.0개월,미발현엄중만기불량반응.6、12개월국부공제솔분별위91％、76％.6례국부미공환자중3례행이정FSRT만구,만구치료후생존시간분별위3、9、13개월.6례환자FSRT후출현치료야외신병조,출현신병조중위시간위4개월.32례환자사망,기중14례사우로내진전,14례사우로외질병진전,1례사우뇌척수막엄범전이,3례사우기타원인(2례폐부감염,1례사인불명).결론 FSRT만구치료대WBRT후복발SCLC뇌전이안전유효.
Objective Evaluation the Fractionated Stereotactic Radiotherapy (FSRT) for the patients with small-cell lung cancer (SCLC) after the whole brain radiotherapy (WBRT) failure.Methods We retrospectively analyzed 35 patients with brain metastases from small-cell lung cancer treated with linear accelerator FSRT after the WBRT failure. Multivariate analysis was used to determine significant prognostic factor related to survival.Results The following-up rate was 100％.The median following-up time was 11 months.The median over-all survival (OS) time was 10.3( 1 -30) months after FSRT.Controlled extra cranial disease was the only identified significant predictor of increased median OS time (χ2 =4.02,P =0.045 ).The median OS time from the diagnosis of brain metastasis was 22 (6 - 134 )months.14 patients died from brain metastasis,14 from extra-cranial progression,1 from leptomeningeal metastases,and 3 from other causes. Local control at 6 months and 12 months was 91％ and 76％,respectively.No significant late complications.New brain metastases outside of the treated area developed in 17％ of patients at a median time of 4(2 -20) months; all patients had received previous WBRT.Conclusions Fractionated stereotactic radiotherapy was safe and effective treatment for recurrent small-cell lung carcinoma brain metastases.