Scholarlink

Background <p>Whole brain radiotherapy (WBRT) is increasingly being replaced by high precision multimodality treatment including stereotactic radiotherapy (SRT) in patients with ≥ 4 brain metastases (BMs). The implications of this trend on survival rates are uncertain. Our study examines the time trends for survival rates of patients treated with radiotherapy for brain metastases during this era of shifting treatment paradigms.</p> Methods <p>Patients with newly diagnosed BMs treated with SRT or WBRT between 2010 and 2023 were included, regardless of the number of brain metastases or the primary malignancy. Patients were excluded if they had previously undergone cranial radiotherapy. Differences in survival between treatment years were evaluated using Log-rank tests. A P value of ≤ 0.05 (two-sided) was considered statistically significant.</p> Results <p>A total of 1106 patients were included for analysis. Of these, 832 (75%) were treated with SRT, while 274 (25%) were treated with WBRT. The median number of BMs was 2 (IQR 1–5), while 367 (33%) patients had ≥ 4 BMs. The proportion of patients with ≥ 4 BMs who were treated with linear accelerator-based SRT instead of WBRT increased over time: 2010–2014: 9 (11%); 2015–2019: 52 (31%); 2020–2023: 80 (68%). An improvement in survival rates of patients with ≥ 4 BMs was observed over time (median survival 2010–2014: 5 months; 2015–2019: 6 months; 2020–2023: 7 months, <i>P</i> &lt; 0.001).</p> Conclusion <p>In patients treated for multiple (≥ 4) BMs, survival increased when radiotherapy modality shifted from WBRT to high precision multimodality treatment including SRT, resection, and systemic therapy.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Paradigm shift in patients with multiple brain metastases from whole brain radiotherapy to high precision multimodality treatment including stereotactic radiotherapy

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月29日

查看全文
  • Jeroen Crouzen,
  • Mirjam Mast,
  • Melissa Kerkhof,
  • Maaike Vos,
  • Thijs van der Vaart,
  • Rishi Nandoe Tewarie,
  • Rob Nabuurs,
  • Ruud Wiggenraad,
  • Mandy Kiderlen,
  • Noëlle van der Voort van Zyp,
  • Anna Petoukhova,
  • Marike Broekman,
  • Jaap Zindler

摘要

Background

Whole brain radiotherapy (WBRT) is increasingly being replaced by high precision multimodality treatment including stereotactic radiotherapy (SRT) in patients with ≥ 4 brain metastases (BMs). The implications of this trend on survival rates are uncertain. Our study examines the time trends for survival rates of patients treated with radiotherapy for brain metastases during this era of shifting treatment paradigms.

Methods

Patients with newly diagnosed BMs treated with SRT or WBRT between 2010 and 2023 were included, regardless of the number of brain metastases or the primary malignancy. Patients were excluded if they had previously undergone cranial radiotherapy. Differences in survival between treatment years were evaluated using Log-rank tests. A P value of ≤ 0.05 (two-sided) was considered statistically significant.

Results

A total of 1106 patients were included for analysis. Of these, 832 (75%) were treated with SRT, while 274 (25%) were treated with WBRT. The median number of BMs was 2 (IQR 1–5), while 367 (33%) patients had ≥ 4 BMs. The proportion of patients with ≥ 4 BMs who were treated with linear accelerator-based SRT instead of WBRT increased over time: 2010–2014: 9 (11%); 2015–2019: 52 (31%); 2020–2023: 80 (68%). An improvement in survival rates of patients with ≥ 4 BMs was observed over time (median survival 2010–2014: 5 months; 2015–2019: 6 months; 2020–2023: 7 months, P < 0.001).

Conclusion

In patients treated for multiple (≥ 4) BMs, survival increased when radiotherapy modality shifted from WBRT to high precision multimodality treatment including SRT, resection, and systemic therapy.