脑部放疗，上午比下午敏感许多！
3 k) V* d5 r+ |' ]$ \! M
% c$ J3 ~9 l+ r; C; I# m' Y( O* ?& V% K) I2 H
Cancer 2011 Jan 15;117(2):414-20. doi: 10.1002/cncr.25423. Epub 2010 Sep 9.
" y t' k! j4 H/ u" z7 |* DGamma knife radiosurgery for brain metastasis of nonsmall cell lung cancer: is there a difference in outcome between morning and afternoon treatment?
2 U$ W4 d1 c# z) ^Rahn DA 3rd, Ray DK, Schlesinger DJ, Steiner L, Sheehan JP, O'Quigley JM, Rich T.
9 m- G/ l" K* rSourceDepartment of Radiation Oncology, University of Virginia Health Sciences Center, Charlottesville, Virginia 22908, USA.
2 l, s2 _0 ?6 n0 u& {8 C" k" U( y
Abstract( G% m8 k4 l! Z% M7 |; x
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.8 Q" K9 V$ f2 N
! Y& U6 H9 G$ b5 }4 Z: T/ P$ o0 wMETHODS: 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.% C% k5 `6 H2 P0 H# O, W/ t0 G
0 y L F- ^9 B3 Q' d1 t- L( \$ u6 XRESULTS: 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).
5 W9 e0 H6 l( y+ q
% C/ ~* ?2 N; [. J& P7 U2 _7 J, OCONCLUSIONS: 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.
0 d% J5 S3 O' {, g$ P. o7 T ^" [
|
显身卡
