Choice of radiotherapy modality for the combined treatment of non-small cell lung cancer with brain metastases: whole-brain radiation therapy with simultaneous integrated boost or stereotactic radiosurgery

Frontiers in Oncology

Oncology

Xiaotao Dong¹  Yanqi Hou¹  Kunlun Wang¹  Yan Li¹  Ling Yuan¹  Jiali Chang¹  Hui Yang¹ 

[1] Department of Radiation Oncology Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, China;

关键词: brain metastasis;    simultaneous integrated boost;    stereotactic radiosurgery;    non-small cell lung cancer;    combined therapy;    radiotherapy;   

DOI  :  10.3389/fonc.2023.1220047

 received in 2023-05-10, accepted in 2023-09-04,  发布年份 2023

来源: Frontiers

【 摘 要 】

PurposeTo compare Whole-brain radiation therapy with simultaneous integrated boost (WBRT+SIB) to stereotactic radiosurgery (SRS)for non-small cell lung cancer (NSCLC)with brain metastases (BMs)in terms of overall survival (OS), intracranial progression-free-survival(iPFS), toxicity and objective response rate (ORR)MethodsA retrospective review was performed in our hospital of 90 patients diagnosed with NSCLC- BM who received either SRS (n = 48) or WBRT+SIB (n = 42) from January 2016 to January 2022. 76 (84.44%) patients received systemic drug therapy after radiotherapy, including chemotherapy(n=53), targeted therapy(n=40), immunotherapy(n=23), and anti-vascular drug therapy(n=45). OS and iPFS were estimated by the Kaplan-Meier method and compared using the log-rank test. Univariate and Multivariate analysis of the prognostic factors was performed using the Cox proportional hazard regression model.ResultsThe WBRT+SIB cohort had a longer median iPFS (20.0 versus (VS) 12.0 months, P = 0.0069) and a similar median OS (32.0 vs 28.0 months, P = 0.195) than the SRS cohort. Intracranial objective response rates in WBRT +SIB and SRS cohorts were 76.19% and 70.09%, respectively (P = 0.566). Disease control rates were 88.09% and 83.33%, respectively (P = 0.521). Multivariate analysis showed that WBRT+SIB is the only factor affecting iPFS(hazard ratio (HR):0.597 {95%confidence interval(CI):0.370-0.966}, P=0.035). Sex, Liver metastasis and Lymph node metastasis are risk factors for NSCLC-BM.ConclusionIn the context of systemic drug therapy, WBRT+SIB may have better intracranial local control than SRS in NSCLC-BM patients.

【 授权许可】

Unknown   
Copyright © 2023 Dong, Wang, Yang, Li, Hou, Chang and Yuan

【 图 表 】

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