PDF(Pubmed)
Abstract：
Randomised control trial data support the use of stereotactic radiosurgery (SRS) in up to 4 brain metastases (BMs), with non-randomised prospective data complementing this for up to 10 BMs. There is debate in the neuro-oncology community as to the appropriateness of SRS in patients with >10 BMs. We present data from a large single-centre cohort, reporting survival in those with >10 BMs and in a >20 BMs subgroup. A total of 1181 patients receiving SRS for BMs were included. Data were collected prospectively from the time of SRS referral. Kaplan-Meier graphs and logrank tests were used to compare survival between groups. Multivariate analysis was performed using the Cox proportional hazards model to account for differences in group characteristics. Median survival with 1 BM (n = 379), 2-4 BMs (n = 438), 5-10 BMs (n = 236), and >10 BMs (n = 128) was 12.49, 10.22, 10.68, and 10.09 months, respectively. Using 2-4 BMs as the reference group, survival was not significantly different in those with >10 BMs in either our univariable (p = 0.6882) or multivariable analysis (p = 0.0564). In our subgroup analyses, median survival for those with >20 BMs was comparable to those with 2-4 BMs (10.09 vs. 10.22 months, p = 0.3558). This study contributes a large dataset to the existing literature on SRS for those with multi-metastases and supports growing evidence that those with >10 BMs should be considered for SRS.
摘要：
随机对照试验数据支持在多达4个脑转移瘤（BMs）中使用立体定向放射外科（SRS）。我们提供来自大型单中心队列的数据,报告>10个BMs和>20个BMs亚组的生存率。总共包括1181名接受SRS的BMs患者。从SRS转诊时开始前瞻性地收集数据。使用Kaplan-Meier图和logrank测试比较各组之间的生存率。使用Cox比例风险模型进行多变量分析，以解释组特征的差异。1BM的中位生存率（n=379），2-4个弹道导弹（n=438），5-10个BM（n=236），和>10BMs（n=128）分别为12.49、10.22、10.68和10.09个月，分别。使用2-4个BM作为参考组，在我们的单变量(p=0.6882)或多变量分析(p=0.0564)中,>10个BMs的患者的生存率无显著差异.在我们的分组分析中，>20例BMs的中位生存期与2-4例BMs的中位生存期相当(10.09vs.10.22个月，p=0.3558）。这项研究为多转移患者的SRS现有文献提供了大量数据集，并支持越来越多的证据表明，应考虑使用>10个BMS的SRS。
