Abstract:
Treatment of a limited number of brain metastases (oligometastases) might include complex and sometimes invasive approaches, e.g. neurosurgical resection followed by post-operative stereotactic radiotherapy, and thus, correct identification of patients who are appropriate candidates is crucial. Both, staging procedures that visualize the true number of metastastic lesions and prognostic assessments that identify patients with limited survival, who should be managed with less complex, palliative approaches, are necessary before proceeding with local treatment that aims at eradication of all oligometastases. Some of the prognostic models, e.g. the LabBM score (laboratory parameters in patients with brain metastases), include blood biomarkers believed to represent surrogate markers of disease extent. In a recent study, patients with oligometastases and a LabBM score of 0 (no abnormal biomarkers) had an actuarial 5-year survival rate of 27% after neurosurgical resection and 39% after stereotactic radiotherapy. Other studies have tied serum tumor markers such as carcinoembryonic antigen (CEA) to survival outcomes. Even if head-to-head comparisons and large-scale definitive analyses are lacking, the available data suggest that attempts to integrate tumor marker levels in blood biomarker-based survival prediction models are warranted.
摘要:
治疗数量有限的脑转移(寡转移)可能包括复杂的,有时是侵入性的方法,例如,神经外科切除术后的立体定向放疗,因此,正确识别合适的患者是至关重要的。两者,分期程序可显示转移病灶的真实数量,并进行预后评估,以确定生存期有限的患者。谁应该用不那么复杂的方式来管理,姑息治疗方法,在进行旨在根除所有寡转移酶的局部治疗之前是必要的。一些预后模型,例如LabBM评分(脑转移患者的实验室参数),包括被认为代表疾病程度的替代标志物的血液生物标志物。在最近的一项研究中,寡转移和LabBM评分为0(无异常生物标志物)的患者,神经外科手术切除后的精算5年生存率为27%,立体定向放疗后的精算5年生存率为39%.其他研究将血清肿瘤标志物如癌胚抗原(CEA)与生存结果联系起来。即使缺乏面对面的比较和大规模的确定性分析,现有数据表明,在基于血液生物标志物的生存预测模型中整合肿瘤标志物水平的尝试是有必要的.