Efficacy and safety of simultaneous integrated boost intensity-modulated radiotherapy for the treatment of lung cancer brain metastases

doi:10.3760/cma.j.cn371439-20240606-00102

Abstract

Abstract:

Objective To analyze the therapeutic effect and safety of simultaneous integrated boost intensity-modulated radiotherapy for lung cancer brain metastases. Methods A total of 300 patients with lung cancer brain metastases admitted to the Department of Oncology， Qingdao Municipal Hospital from March 2021 to March 2023 were selected as the study objects. The patients were divided into control group （n=150） and study group （n=150） by random number table method. The control group received sequential three-dimensional conformal radiotherapy， while the study group received simultaneous integrated boost intensity-modulated radiotherapy. The short-term and medium-term efficacy， target dose， and adverse reactions were compared between the two groups. Results The short-term and medium-term total effective rates of the study group were 73.33% （110/150） and 88.67% （133/150）， respectively， which were higher than those of the control group [51.33% （77/150） and 71.33% （107/150）] （χ²=15.46， P<0.001； χ²=14.08， P<0.001）. The D_min in gross tumor planning target volume and whole brain clinical planning target volume of the study group were （23.78±1.11） and （58.46±0.55） Gy， respectively， which were higher than those in the control group [（16.67±1.08） and （53.44±0.74） Gy]， with statistically significant differences （t=56.22， P<0.001； t=66.68， P<0.001）. The D_mean in gross tumor planning target volume and whole brain clinical planning target volume of the study group were （44.12±0.87） and （62.19±0.57） Gy， respectively， which were higher than those in the control group [（37.55±0.89） and （57.78±0.82） Gy]， with statistically significant differences （t=64.65， P<0.001； t=54.08， P<0.001）. The total incidence of adverse reactions was 30.67% （46/150） in the study group and 36.67% （55/150） in the control group， with no significantly significant difference （χ²=1.20， P=0.271）. Conclusion Compared with sequential three-dimensional conformal radiotherapy， simultaneous integrated boost intensity-modulated radiotherapy has better short-term and medium-term efficacy in patients with lung cancer brain metastases. Target dose can be increased without increasing adverse reactions.

Key words: Lung neoplasms, Radiotherapy， intensity-modulated, Brain metastases

Yang Jing, Liu Fang, Ma Meili, Huang Dongshuai, Wang Junhua. Efficacy and safety of simultaneous integrated boost intensity-modulated radiotherapy for the treatment of lung cancer brain metastases[J]. Journal of International Oncology, 2024, 51(10): 609-613.

Figures/Tables 5

References 17

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项目	对照组（n=150）	研究组（n=150）	χ²/t值	P值
性别
男	80（53.33）	76（50.67）	0.21	0.643
女	70（46.67）	74（49.33）	0.21	0.643
年龄（岁）
40~50	25（16.67）	29（19.33）
51~60	46（30.67）	48（32.00）	0.58	0.750
>60	79（52.66）	73（48.67）
颅内病灶数（个）
1	89（59.33）	93（62.00）	0.22	0.636
≥2	61（40.67）	57（38.00）	0.22	0.636
病程（月）	1.66±0.38	1.69±0.42	0.64	0.517
病理类型
小细胞癌	34（22.67）	30（20.00）	0.52	0.946
腺癌	98（65.33）	100（66.67）
鳞状细胞癌	15（10.00）	16（10.67）
腺鳞癌	3（2.00）	4（2.66）

组别	完全缓解	部分缓解	病情稳定	疾病进展	总有效
对照组（n=150）	27（18.00）	23（15.33）	27（18.00）	73（48.67）	77（51.33）
研究组（n=150）	37（24.67）	47（31.33）	26（17.33）	40（26.67）	110（73.33）
χ²值					15.46
P值					<0.001

组别	完全缓解	部分缓解	病情稳定	疾病进展	总有效
对照组（n=150）	37（24.67）	40（26.67）	30（20.00）	43（28.67）	107（71.33）
研究组（n=150）	40（26.67）	60（40.00）	33（22.00）	17（11.33）	133（88.67）
χ²值					14.08
P值					<0.001

组别	骨髓抑制	贫血	记忆损伤	头晕	呕吐	癫痫	合计
对照组（n=150）	5（3.33）	10（6.67）	10（6.67）	13（8.67）	7（4.66）	10（6.67）	55（36.67）
研究组（n=150）	3（2.00）	6（4.00）	7（4.67）	11（7.33）	9（6.00）	10（6.67）	46（30.67）