脑部放疗，上午比下午敏感许多！, \" ~ p) d' r) P# F
3 E8 ?: b* b6 `* L' v( b
$ R: s. ?: E3 R' y' W7 h# W5 Y" V0 _$ RCancer 2011 Jan 15;117(2):414-20. doi: 10.1002/cncr.25423. Epub 2010 Sep 9.8 F) }4 J; i9 X: H" Q. O
Gamma knife radiosurgery for brain metastasis of nonsmall cell lung cancer: is there a difference in outcome between morning and afternoon treatment?
( G# R! S# _9 c4 T7 [) c- gRahn DA 3rd, Ray DK, Schlesinger DJ, Steiner L, Sheehan JP, O'Quigley JM, Rich T.
9 x+ B: J5 B9 e/ B. lSourceDepartment of Radiation Oncology, University of Virginia Health Sciences Center, Charlottesville, Virginia 22908, USA.! M1 f2 T$ C5 W
3 w. |, }4 f( U5 m/ w- FAbstract3 t: J+ m |1 w" }# `: i
BACKGROUND: Circadian cell-cycle progression causes fluctuating radiosensitivity in many tissues, which could affect clinical outcomes. The purpose of this study was to determine whether outcomes of single-session gamma knife radiosurgery (GKRS) for metastatic nonsmall cell lung cancer (NSCLC) differ based on treatment time.- V" m: I6 I' H6 P' T4 J
. r. p- L. A1 V# B t9 qMETHODS: Fifty-eight patients received GKRS between 10:00 am and 12:30 pm and 39 patients received GKRS between 12:30 pm and 3:00 pm. The mean peripheral dose was 18.6 Gy. The mean tumor size was 7.3 cm³. Magnetic resonance imaging was used to score local control at 3 months. Cause of death (COD) was categorized as central nervous system (CNS)-related or systemic.8 J' V8 G1 m( H; `( L* D \1 V
) K9 i$ {8 ^' G) b5 k
RESULTS: Demographic and disease characteristics of the 2 groups were similar. Local control at 3 months was achieved in 97% (35/36) of patients who underwent GKRS early in the day versus 67% (8/12) of patients who underwent GKRS later in the day (chi-square, P = .014). Early GKRS was associated with better survival (median 9.5 months) than late GKRS (median 5 months) (Kaplan-Meier log-rank test, P = .025). Factors contributing to better survival in a Cox regression model included early treatment time (P = .004) and recursive partition analysis class (P < .001). Cause of death in the early treatment group was CNS-related in 6% (3/47) of patients versus 24% (8/34) of patients in the late treatment group (chi-square test, P = .026)." o, z9 }- f7 A
, [, j: u! d+ n( W
CONCLUSIONS: GKRS for metastatic NSCLC had better local control, better survival, and a lower rate of CNS-related cause of death when given earlier in the day versus later in the day. These retrospective data should encourage future study in brain radiosurgery and non-CNS stereotactic body radiotherapy series.
7 D5 w3 G( Q8 Z! K, {1 m4 H7 B: R; [, p4 M/ M
|
7 [* [, I$ f# Z
显身卡
