دورية أكاديمية
Reduced-dose WBRT combined with SRS for 1–4 brain metastases aiming at minimizing neurocognitive function deterioration without compromising brain tumor control
| العنوان: | Reduced-dose WBRT combined with SRS for 1–4 brain metastases aiming at minimizing neurocognitive function deterioration without compromising brain tumor control |
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| المؤلفون: | Toshimichi Nakano, Hidefumi Aoyama, Shunsuke Onodera, Hiroshi Igaki, Yasuo Matsumoto, Ayae Kanemoto, Shigetoshi Shimamoto, Masayuki Matsuo, Hidekazu Tanaka, Natsuo Oya, Tomohiko Matsuyama, Atsushi Ohta, Katsuya Maruyama, Takahiro Tanaka, Nobutaka Kitamura, Kohei Akazawa, Katsuya Maebayashi |
| المصدر: | Clinical and Translational Radiation Oncology, Vol 37, Iss , Pp 116-129 (2022) |
| بيانات النشر: | Elsevier, 2022. |
| سنة النشر: | 2022 |
| المجموعة: | LCC:Medical physics. Medical radiology. Nuclear medicine LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens |
| مصطلحات موضوعية: | Brain metastases, Cognition, Recurrence, Radiation, Whole brain, Stereotactic radiosurgery, Medical physics. Medical radiology. Nuclear medicine, R895-920, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282 |
| الوصف: | Background and purpose: To minimize cognitive decline without increasing brain tumor recurrence (BTR) by reduced-dose whole-brain radiotherapy (RD-WBRT) (25 Gy, 10 fractions) + stereotactic radiosurgery (SRS) in patients with ≤ 4 brain metastases. Materials and methods: Eligible patients with ≤ 4 brain metastases on contrast-enhanced MRI and Karnofsky Performance Status ≥ 70. The primary endpoint was the non-inferiority of BTR at distant sites in the brain (BTR-distant)-free survival at 6 months compared to that of the standard dose (SD)-WBRT (30 Gy, 10 fractions) + SRS arm in a randomized clinical trial (JROSG99-1) of SRS with/without SD-WBRT. Secondary endpoints included BTR at any brain sites (BTR-all) and neurocognitive function assessed by a six-test standardized battery. Results: Forty patients from seven institutions were enrolled (median age 69 years). The primary tumor site was a lung in 28 patients; 20 patients had a solitary brain metastasis. The median survival time was 19.0 months (95 %CI: 13.8 %–27.5 %). The BTR-distant-free survival at 6 months was 76.9 % (59.5 %–87.7 %), which is comparable to that of historical control although predetermined non-inferiority (>71 %) could not be confirmed (p = 0.16). The cumulative incidence of BTR-all at 6 months accounting for the competing risk of death was 23.0 % (11.4–37.1), which was not worse than that of historical control (p = 0.774). The frequency of the cumulative incidence of persistent cognitive decline at 6 months was 48.6 % under the [>2.0 SD in ≥ 1 test] definition. Conclusions: RD-WBRT may yield comparable intracranial tumor control when combined with SRS, and may reduce the risk of neurocognitive decline compared to that after SD-WBRT. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2405-6308 |
| Relation: | http://www.sciencedirect.com/science/article/pii/S2405630822000805; https://doaj.org/toc/2405-6308 |
| DOI: | 10.1016/j.ctro.2022.09.005 |
| URL الوصول: | https://doaj.org/article/bd2d474366a6411c9c64e132744333e1 |
| رقم الأكسشن: | edsdoj.bd2d474366a6411c9c64e132744333e1 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 24056308 |
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| DOI: | 10.1016/j.ctro.2022.09.005 |