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Abstract：
Background: Discontinuation of radiotherapy is rarely discussed in the scientific literature. The goal of this study was, therefore, to estimate the frequency of and reasons for treatment discontinuations in patients receiving radiotherapy for brain metastases from solid tumors and to identify factors predicting said discontinuations. Methods: All patients treated for brain metastases from solid tumors between 2010 and 2020 at our institution were retrospectively reviewed. In addition to collecting relevant patient characteristics, the Recursive Partitioning Analysis (RPA) and disease-specific Graded Prognostic Assessment (GPA) groups for each patient were calculated to assess the performance of these scores in predicting treatment discontinuations. Results: Out of 468 patients who underwent cranial radiotherapy, 35 treatments (7.5%) were discontinued. The most frequent reason was clinical deterioration, which was documented in 26 (74.3%) of discontinued treatments. Patients whose radiotherapy was discontinued had, on average, more leptomeningeal disease (20.0% vs. 12.6%), worse ECOG performance status (mean ECOG performance status 1.86 vs. 1.39), and more uncontrolled extracranial metastases (85.3% vs. 70.8%). The frequencies of treatment discontinuation increased with worse prognosis and differed significantly across RPA groups (p = 0.037) but not across GPA groups (p = 0.612). Conclusions: Treatment discontinuation occurred in 7.5% of cases, mostly due to clinical deterioration. Poor performance status, as well as more advanced disease and, in turn, poor prognosis, were associated with higher discontinuation rates.
摘要：
背景：停止放疗在科学文献中很少讨论。这项研究的目的是,因此,评估接受放射疗法治疗的实体肿瘤脑转移患者停药的频率和原因，并确定预测停药的因素。方法：回顾性分析2010年至2020年在我院接受治疗的所有实体肿瘤脑转移患者。除了收集相关患者特征外，对每位患者的递归分区分析(RPA)和疾病特异性分级预后评估(GPA)组进行了计算,以评估这些评分在预测治疗中断方面的表现.结果：在468例接受头颅放疗的患者中，35次治疗(7.5%)停止。最常见的原因是临床恶化，在26例(74.3%)中断治疗中记录了这一点。停止放疗的患者，平均而言,更多的软脑膜疾病（20.0%vs.12.6%），更差的ECOG绩效状态(平均ECOG绩效状态1.86与1.39),和更多不受控制的颅外转移(85.3%vs.70.8%）。治疗中断的频率随着预后的恶化而增加，并且在RPA组之间存在显着差异（p=0.037），而在GPA组之间则没有差异（p=0.612）。结论：治疗中断发生在7.5%的病例中，主要是由于临床恶化。性能状态差,以及更晚期的疾病，反过来,预后不良,与更高的停药率相关。
