脑部放疗，上午比下午敏感许多！7 q( T" v; A& N# |2 R
, W% ^0 {9 h, s5 c! ]# d
0 r9 t" L) W' A& {: I6 m
Cancer 2011 Jan 15;117(2):414-20. doi: 10.1002/cncr.25423. Epub 2010 Sep 9.
' s4 F2 X/ c1 ~) B# ^Gamma knife radiosurgery for brain metastasis of nonsmall cell lung cancer: is there a difference in outcome between morning and afternoon treatment?5 X8 I3 D" A$ B5 u
Rahn DA 3rd, Ray DK, Schlesinger DJ, Steiner L, Sheehan JP, O'Quigley JM, Rich T.
$ p2 Z/ t5 h# H( j: qSourceDepartment of Radiation Oncology, University of Virginia Health Sciences Center, Charlottesville, Virginia 22908, USA.# w) L4 @3 h3 o. y+ h9 O8 f
- C0 a K! {0 C a9 u$ MAbstract2 r5 d0 k F/ {5 I4 p
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.
4 y/ J8 L8 k3 B: ^* C6 W! e- V+ ~
7 j! G% j7 E1 v* CMETHODS: 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.
1 j( P# z- p+ a3 [* `1 X! k
2 T' j4 e) `7 b/ S- N, vRESULTS: 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).
7 R) Q' U- o' D
5 |/ v& ]0 y& a, t0 W6 @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 A$ Y7 t1 k
, U: P! H& z% q" n/ z7 R2 `4 N |
显身卡
