期刊
CANCER BIOLOGY & MEDICINE
卷 19, 期 6, 页码 884-892出版社
CHINA ANTI-CANCER ASSOC
DOI: 10.20892/j.issn.2095-3941.2020.0598
关键词
Surgery; radiosurgery; brain metastasis; therapy; overall survival
资金
- Tianjin Municipal Science and Technology Commission [18JCYBJC27600]
There is no general consensus on the optimal treatment for multiple brain metastases. Radiotherapy is commonly used, while the role of surgical resection is unclear. This study compared the outcomes of surgery and stereotactic radiosurgery (SRS) in patients with multiple brain metastases and found that they have similar overall survival and local tumor control rates.
Objective: Multiple brain metastases are a severe condition for cancer patients. To date, no general consensus exists regarding the optimal treatment procedure for multiple brain metastases. Radiotherapy is the most commonly used treatment option. The role of surgical resection for multiple brain metastases is unclear. The aim of this study was to compare the outcomes of patients with multiple brain metastases treated with either surgery or stereotactic radiosurgery (SRS). Methods: The medical records of 279 consecutive adult patients with multiple brain metastases treated with either surgery (26 patients) or SRS (253 patients) were retrospectively reviewed. Propensity score matching was conducted to correct for discrepancies in the baseline characteristics, and 78 patients (26 receiving surgery and 52 receiving SRS) were chosen for comparison of outcomes, such as overall survival, local tumor control rate, and symptom improvement. Results: The tumor size in the surgery group was significantly greater than that in the SRS group after propensity score matching. However, the neurological recovery rate, incidence of leptomeningeal metastasis after surgery, 1-year local tumor control rate, and overall survival were not significantly different between groups. Conclusions: Our data demonstrate that surgery and radiosurgery have identical overall survival and local tumor control rates in patients with 2 to 4 brain metastases. Although SRS remains the primary and standard option for patients with brain metastasis, surgery offers several distinct advantages, such as establishing a diagnosis or relieving mass effects, and may additionally be beneficial in carefully selected patients with 2-4 brain metastases.
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