脑部放疗，上午比下午敏感许多！
_, p4 s3 z6 Z* _ ], r* b. Y( n. v
7 `$ i7 ]$ @' u& w5 C% G: wCancer 2011 Jan 15;117(2):414-20. doi: 10.1002/cncr.25423. Epub 2010 Sep 9.) D& d1 a3 D* M& }& ~5 ]
Gamma knife radiosurgery for brain metastasis of nonsmall cell lung cancer: is there a difference in outcome between morning and afternoon treatment?
3 M1 f, N9 a# \1 P/ F0 g ~ N4 v# J& f( KRahn DA 3rd, Ray DK, Schlesinger DJ, Steiner L, Sheehan JP, O'Quigley JM, Rich T.
8 G, k( V5 A$ f5 I# D) q/ ~SourceDepartment of Radiation Oncology, University of Virginia Health Sciences Center, Charlottesville, Virginia 22908, USA.( S! `) [6 L- ^" ]1 I. v
6 \, \; V) \7 B& t7 m% @0 {, ^4 v. ZAbstract; P( `4 a# ~8 U" a( r3 n
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./ @+ |- ^# Y5 P D- e% Q
8 w5 J* ?/ z" J" C% f* U/ x
METHODS: 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." Q( ]( o$ i: |* c8 Q9 p
# F* f: Z4 u0 ^3 [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).
6 A6 w7 X4 V0 H6 c2 }: X) N1 |
y @; L) M2 E( p! t1 t# N$ t: ]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.' N3 H$ B+ ?$ f2 c/ G, V# A, s
; N9 D. P& r; F! p- j; L
|
显身卡
