PDF(Pubmed)
Abstract：
UNASSIGNED: Evaluate effectiveness and safety of multiple HyperArc courses and patterns of progression in patients affected by BMs with intracranial progression.
UNASSIGNED: 56 patients were treated for 702 BMs with 197 (range 2-8) HyperArc courses in case of exclusive intracranial progression. Primary end-point was the overall survival (OS), secondary end-points were intracranial progression-free survival (iPFS), toxicity, local control (LC), neurological death (ND), and whole-brain RT (WBRT)-free survival. Site of progression was evaluated against isodoses levels (0, 1, 2, 3, 5, 7, 8, 10, 13, 15, 20, and 24 Gy.).
UNASSIGNED: The 1-year OS was 70 %, and the median was 20.8 months (17-36). At the univariate analysis (UVA) biological equivalent dose (BED) > 51.3 Gy and non-melanoma histology significantly correlated with OS. The median time to iPFS was 4.9 months, and the 1-year iPFS was 15 %. Globally, 538 new BMs occurred after the first HA cycle in patients with extracranial disease controlled. 96.4 % of them occurred within the isodoses range 0-7 Gy as follows: 26.6 % (0 Gy), 16.5 % (1 Gy), 16.5 % (2 Gy), 20.1 % (3 Gy), 13.1 % (5 Gy), 3.4 % (7 Gy) (p = 0.00). Radionecrosis occurred in 2 metastases (0.28 %). No clinical toxicity of grade 3 or higher occurred during follow-up. One- and 2-year LC was 90 % and 79 %, respectively. At the UVA BED > 70 Gy and non-melanoma histology were significant predictors of higher LC. The 2-year WBRT-free survival was 70 %. After a median follow-up of 17.4 months, 12 patients deceased by ND.
UNASSIGNED: Intracranical relapses can be safely and effectively treated with repeated HyperArc, with the aim to postpone or avoid WBRT. Diffuse dose by volumetric RT might reduce microscopic disease also at relatively low levels, potentially acting as a virtual CTV. Neurological death is not the most common cause of death in this population, which highlights the impact of extracranial disease on overall survival.
UNASSIGNED: 56 patients were treated for 702 BMs with 197 (range 2-8) HyperArc courses in case of exclusive intracranial progression. Primary end-point was the overall survival (OS), secondary end-points were intracranial progression-free survival (iPFS), toxicity, local control (LC), neurological death (ND), and whole-brain RT (WBRT)-free survival. Site of progression was evaluated against isodoses levels (0, 1, 2, 3, 5, 7, 8, 10, 13, 15, 20, and 24 Gy.).
UNASSIGNED: The 1-year OS was 70 %, and the median was 20.8 months (17-36). At the univariate analysis (UVA) biological equivalent dose (BED) > 51.3 Gy and non-melanoma histology significantly correlated with OS. The median time to iPFS was 4.9 months, and the 1-year iPFS was 15 %. Globally, 538 new BMs occurred after the first HA cycle in patients with extracranial disease controlled. 96.4 % of them occurred within the isodoses range 0-7 Gy as follows: 26.6 % (0 Gy), 16.5 % (1 Gy), 16.5 % (2 Gy), 20.1 % (3 Gy), 13.1 % (5 Gy), 3.4 % (7 Gy) (p = 0.00). Radionecrosis occurred in 2 metastases (0.28 %). No clinical toxicity of grade 3 or higher occurred during follow-up. One- and 2-year LC was 90 % and 79 %, respectively. At the UVA BED > 70 Gy and non-melanoma histology were significant predictors of higher LC. The 2-year WBRT-free survival was 70 %. After a median follow-up of 17.4 months, 12 patients deceased by ND.
UNASSIGNED: Intracranical relapses can be safely and effectively treated with repeated HyperArc, with the aim to postpone or avoid WBRT. Diffuse dose by volumetric RT might reduce microscopic disease also at relatively low levels, potentially acting as a virtual CTV. Neurological death is not the most common cause of death in this population, which highlights the impact of extracranial disease on overall survival.
摘要：
■评估受颅内进展的BM影响的患者的多个HyperArc疗程和进展模式的有效性和安全性。
■56例患者接受了702例BMs治疗，其中有197个（范围2-8个）HyperArc疗程。主要终点是总生存期（OS），次要终点为颅内无进展生存期(iPFS),毒性,本地控制（LC），神经死亡（ND），和全脑无RT(WBRT)生存。针对等剂量水平(0、1、2、3、5、7、8、10、13、15、20和24Gy评估进展部位。).
■1年操作系统为70%，中位数为20.8个月（17-36）。在单变量分析(UVA)生物等效剂量(BED)>51.3Gy和非黑素瘤组织学与OS显著相关。iPFS的中位时间为4.9个月，一年的iPFS为15%。全球范围内,在颅外疾病控制的患者中，第一个HA周期后发生了538例新的BMs。其中96.4％发生在0-7Gy的等剂量范围内，如下所示：26.6％（0Gy），16.5%（1Gy），16.5%（2Gy），20.1%（3Gy），13.1%（5Gy），3.4%(7Gy)(p=0.00)。放射性坏死发生在2个转移灶（0.28％）中。随访期间未发生3级或更高的临床毒性。一年期和两年期LC分别为90%和79%，分别。在UVABED>70Gy和非黑色素瘤组织学是较高LC的重要预测因子。2年无WBRT生存率为70%。经过17.4个月的中位随访，12例因ND死亡的患者。
■反复的HyperArc可以安全有效地治疗颅内复发，目的是推迟或避免WBRT。通过体积RT的扩散剂量可能会在相对较低的水平上减少微观疾病，可能充当虚拟CTV。神经系统死亡不是该人群中最常见的死亡原因，这突出了颅外疾病对总生存率的影响。
■56例患者接受了702例BMs治疗，其中有197个（范围2-8个）HyperArc疗程。主要终点是总生存期（OS），次要终点为颅内无进展生存期(iPFS),毒性,本地控制（LC），神经死亡（ND），和全脑无RT(WBRT)生存。针对等剂量水平(0、1、2、3、5、7、8、10、13、15、20和24Gy评估进展部位。).
■1年操作系统为70%，中位数为20.8个月（17-36）。在单变量分析(UVA)生物等效剂量(BED)>51.3Gy和非黑素瘤组织学与OS显著相关。iPFS的中位时间为4.9个月，一年的iPFS为15%。全球范围内,在颅外疾病控制的患者中，第一个HA周期后发生了538例新的BMs。其中96.4％发生在0-7Gy的等剂量范围内，如下所示：26.6％（0Gy），16.5%（1Gy），16.5%（2Gy），20.1%（3Gy），13.1%（5Gy），3.4%(7Gy)(p=0.00)。放射性坏死发生在2个转移灶（0.28％）中。随访期间未发生3级或更高的临床毒性。一年期和两年期LC分别为90%和79%，分别。在UVABED>70Gy和非黑色素瘤组织学是较高LC的重要预测因子。2年无WBRT生存率为70%。经过17.4个月的中位随访，12例因ND死亡的患者。
■反复的HyperArc可以安全有效地治疗颅内复发，目的是推迟或避免WBRT。通过体积RT的扩散剂量可能会在相对较低的水平上减少微观疾病，可能充当虚拟CTV。神经系统死亡不是该人群中最常见的死亡原因，这突出了颅外疾病对总生存率的影响。
