| Chang Fangfang,Xia Xiaodong,Li Mengni,et al.Survival of patients with brain metastases from small cell lung cancer under different intracranial radiotherapy modalities[J].Chinese Journal of Radiological Medicine and Protection,2024,44(11):924-930 |
| Survival of patients with brain metastases from small cell lung cancer under different intracranial radiotherapy modalities |
| Received:December 14, 2023 |
| DOI：10.3760/cma.j.cn112271-20231214-00211 |
| KeyWords:Radiotherapy Systemic therapy Small cell lung cancer Prognostic analysis Brain metastasis |
| FundProject:安徽省高等学校科学研究重点项目(2022AH051446) |
| Author Name | Affiliation | E-mail | | Chang Fangfang | Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China
Department of Radiation Oncology, Second Affiliated Hospital of Bengbu Medical University, Bengbu 233000, China | | | Xia Xiaodong | Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China | | | Li Mengni | Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China | | | Guo Ziwen | Second Affiliated Hospital of Wannan Medical College, Wuhu 241000, China | | | Liu Jia | Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China | | | Jiang Hao | Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China | | | Cui Zhen | Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China | cuizhen1128@163.com |
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| Abstract:: |
| Objective To explore the prognostic impact of different intracranial radiotherapy modalities in patients with a limited number (≤10) of brain metastases from small cell lung cancer (SCLC-BM). Methods The data of 143 cases with SCLC-BM that received intracranial radiotherapy at the First Affiliated Hospital of Bengbu Medical University in 2019-2022 were analyzed. The patients were grouped by radiotherapy modalities: whole brain radiotherapy (WBRT, 58 cases), WBRT combined with simultaneous integrated boost (WBRT+SIB, 53 cases), and WBRT combined with sequential integrated boost (WBRT+SEB, 32 cases). The overall survival (OS) and intracranial progression-free survival (IPFS) were calculated using the Kaplan-Meier method, and the Cox proportional hazard model was used for prognostic analysis. Results In the whole group, the median OS and IPFS were 11.9 and 9.9 months, and the 1-, 2-, and 3-year survival rates were 49.7%, 15.3%, and 2.9%, respectively. The difference in OS among patients in the WBRT+SIB, WBRT+SEB, and WBRT groups was not significant (median OS: 13.0 months vs. 12.5 months vs. 11.2 months, P>0.05). The WBRT+SIB and WBRT+SEB groups were preferred over the WBRT group in terms of IPFS (median IPFS: 11.7 months vs. 10.4 months vs. 8.1 months, χ2=21.69, P<0.001). For patients with few brain metastases (≤3) analyzed separately, the WBRT+SIB and WBRT+SEB groups were preferred over the WBRT group in terms of OS and IPFS (median OS: 14.4 months vs. 13.7 months vs. 11.5 months, χ2=8.72, P=0.013; median IPFS: 12.6 months vs. 10.4 months vs. 8.9 months, χ2=12.37, P=0.002). Evaluation of the central nervous system as well as hematological acute radiological reactions reaching grade 2 and above showed no significant differences among the three groups (P>0.05). Multivariate analysis showed that subsequent chemotherapy, targeted therapy, and immunotherapy were common independent influencing factors for patients' OS and IPFS. Body mass index (BMI) level was an independent influencing factor for patients' OS, and the number of brain metastases, lymph node metastasis, and radiotherapy modality were independent influencing factors for patients' IPFS. Conclusions BMI level and subsequent treatment (chemotherapy, targeted therapy, and immunotherapy) are independent influencing factors for patients' prognosis. WBRT+SIB and WBRT+SEB modalities are associated with increased IPFS. |
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