METHODS: A total of 35 consecutive patients, prospectively recruited within a study registry, who received IORT following BM resection at a single neuro-oncological center were evaluated for radiation necrosis (RN) incidence rates, local control rates (LCR), distant brain progression (DBP) and overall survival (OS) as long-term outcome parameters. The 1 year-estimated OS and survival rates were compared in a balanced comparative matched-pair analysis to those of our institutional database, encompassing 388 consecutive patients who underwent adjuvant EBRT after BM resection.
RESULTS: The median IORT dose was 30 Gy prescribed to the applicator surface. A 2.9% RN rate was observed. The estimated 1 year-LCR was 97.1% and the 1 year-DBP-free survival 73.5%. Median time to DBP was 6.4 (range 1.7-24) months in the subgroup of patients experiencing intracerebral progression. The median OS was 17.5 (0.5-not reached) months with a 1 year-survival rate of 61.3%, which did not not significantly differ from the comparative cohort (p = 0.55 and p = 0.82, respectively).
CONCLUSIONS: IORT is a safe and effective fast-track approach following BM resection, with comparable long-term outcomes as adjuvant EBRT.
方法:共有35名连续患者,在研究登记处前瞻性招募,在单个神经肿瘤中心接受BM切除后接受IORT的患者进行放射性坏死(RN)发生率评估,本地控制率(LCR),远端脑进展(DBP)和总生存期(OS)作为长期结局参数。在平衡比较配对分析中,将1年估计的OS和生存率与我们的机构数据库进行了比较,纳入了在BM切除术后接受辅助性EBRT的388例连续患者。
结果:给涂药器表面的IORT剂量中位数为30Gy。观察到2.9%的RN率。估计1年LCR为97.1%,1年无DBP生存率为73.5%。在经历脑内进展的患者亚组中,DBP的中位时间为6.4(范围1.7-24)个月。中位OS为17.5个月(未达到0.5个月),1年生存率为61.3%,与比较队列没有显着差异(分别为p=0.55和p=0.82)。
结论:IORT是BM切除后安全有效的快速途径,与辅助EBRT具有相当的长期结局。