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Chemotherapy combined with bevacizumab for small cell lung cancer with brain metastases:A case report
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作者 Hong-Yu Yang Yu-Qing Xia +3 位作者 Yu-Jia Hou Peng Xue Shi-Jie Zhu Dian-Rong Lu 《World Journal of Clinical Cases》 SCIE 2024年第2期405-411,共7页
BACKGROUND Small cell lung cancer(SCLC)is a common and aggressive subtype of lung cancer.It is characterized by rapid growth and a high mortality rate.Approximately 10%of patients with SCLC present with brain metastas... BACKGROUND Small cell lung cancer(SCLC)is a common and aggressive subtype of lung cancer.It is characterized by rapid growth and a high mortality rate.Approximately 10%of patients with SCLC present with brain metastases at the time of diagnosis,which is associated with a median survival of 5 mo.This study aimed to summarize the effect of bevacizumab on the progression-free survival(PFS)and overall survival of patients with brain metastasis of SCLC.CASE SUMMARY A 62-year-old man was referred to our hospital in February 2023 because of dizziness and numbness of the right lower extremity without headache or fever for more than four weeks.The patient was diagnosed with limited-stage SCLC.He received 8 cycles of chemotherapy combined with maintenance bevacizumab therapy and achieved a PFS of over 7 mo.CONCLUSION The combination of bevacizumab and irinotecan effectively alleviated brain metastasis in SCLC and prolonged PFS. 展开更多
关键词 Small cell lung cancer BEVACIZUMAB brain metastasis Antineoplastic agents Target therapies IMMUNOTHERAPY radiotherapy Case report
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MRI/CT融合图像与CT图像勾画海马区在HP-WBRT中TOMO适宜参数的研究
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作者 邓雅鑫 张震 《中国医疗设备》 2024年第9期35-42,共8页
目的探索MRI/CT融合图像与CT图像在勾画海马区时,螺旋断层放射治疗技术(Tomotherapy,TOMO)应用于海马保护性全脑放射治疗的适宜参数。方法选取2017年1月至2022年12月间在陕西省肿瘤医院实施海马保护性全脑放射治疗的66例患者数据为研究... 目的探索MRI/CT融合图像与CT图像在勾画海马区时,螺旋断层放射治疗技术(Tomotherapy,TOMO)应用于海马保护性全脑放射治疗的适宜参数。方法选取2017年1月至2022年12月间在陕西省肿瘤医院实施海马保护性全脑放射治疗的66例患者数据为研究对象,其中36例患者海马区使用MRI/CT融合图像进行勾画,30例患者使用CT图像进行勾画。通过调整不同的调制因子(Modulation Factor,MF)、射野宽度(Field Width,FW)和螺距(Pitch)参数,采用不同的参数组合,评估治疗计划的靶区覆盖率和危及器官剂量,以探索适用于TOMO的合适参数。结果基于MRI/CT融合图像勾画的海马区体积(HPL、HPR两侧)显著大于基于CT图像勾画的海马区体积(P<0.001)。使用MRI/CT融合图像勾画海马区时,TOMO的最佳MF取值为2.7,使用CT图像勾画时最佳取值则为2.5;两者的FW最佳值均为2.5 cm;MRI/CT融合图像的Pitch最佳值为0.287,CT的Pitch取值为0.287和0.430时均符合要求。结论通过比较MRI/CT融合图像和CT图像勾画海马区时的不同参数方案,得出适用于海马保护性全脑放射治疗的TOMO适宜参数,可为优化放疗方案,提高海马保护性全脑放射治疗的准确性和安全性提供参考。 展开更多
关键词 海马保护性全脑放射治疗 螺旋断层放射治疗技术 调制因子 射野宽度 螺距
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Therapeutic Effects of Stereotactic Radiotherapy on 389 Cases of Brain Glioma 被引量:1
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作者 牛道立 何中 胡慧玲 《The Chinese-German Journal of Clinical Oncology》 CAS 2005年第4期221-224,共4页
Objective: To investigate the treatment effectiveness and side effects of stereotactic radiotherapy for brain glioma. Methods: From Jun. 1995 to Dec. 1998, 389 cases of brain gliomas were treated by stereotactic rad... Objective: To investigate the treatment effectiveness and side effects of stereotactic radiotherapy for brain glioma. Methods: From Jun. 1995 to Dec. 1998, 389 cases of brain gliomas were treated by stereotactic radiotherapy, among which 151 cases were treated by stereotactic radiosurgery (SRS) and the other 238 cases, by fractionated stereotactic radiotherapy (FSRT). In the SRS group, the marginal tumor dose was 20 to 30 Gy (median, 2.6 Gy). One to 6 isocenters (median, 2.48) and 5 to 21 irradiation arcs (median, 8.45) were applied. In the FSRT group, the per-fraction marginal tumor dose was 8 to 12 Gy with 1 to 6 isocenters (median, 2.53), 6 to 20 irradiation arcs (median, 8.25) and 2-5 fractions delivered everyday or every other day. Results: Three months after treatment, the complete and partial response rates were 13.9% and 45.7% in SRS group respectively. The stable disease rate was 17.2%. The total effective rate was 76.8%. In FSRT group, the complete and partial remission rates were 19.7% and 47.9% respectively. The stable disease rate was 20.6%. The total effective rate was 88.2%. The total effective rate of FSRT group was higher than that in SRS group (X^2=9.874, P=0.020). The 1-year, 3-year and 5-year survival rate of all patients was 54.3%, 29.3%, 16.5% respectively. The 1-year, 3-year and 5-year survival rate in SRS group and FSRT group was 52.3% vs 26.5%, 11.9% vs 55.5%, and 31.1 vs 19.3% respectively. There was no significant difference between the two groups (X^2=2.16, P=0.1417). The brain edema caused by the main radiation was more severe in the SRS group than in FSRT group (X^2=4.916, P=0.027). Conclusion: It is effective for brain glioma to be treated by stereotactic radiotherapy. Compared with SRS, the FSRT has the advantage of good effect and less side response. 展开更多
关键词 fractionated stereotactic radiotherapy stereotactic radiosurgery brain glioma PROGNOSIS
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Could helical tomotherapy do whole brain radiotherapy and radiosurgery? 被引量:5
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作者 Youlia M Kirova Cyrus Chargari +1 位作者 Sofia Zefkili Franois Campana 《World Journal of Radiology》 CAS 2010年第4期148-150,共3页
Whole brain radiotherapy (WBRT) remains the standard management of breast cancer patients with brain metastases, allowing for symptomatic improvement and good local control in most patients. However, its results remai... Whole brain radiotherapy (WBRT) remains the standard management of breast cancer patients with brain metastases, allowing for symptomatic improvement and good local control in most patients. However, its results remain suboptimal in terms of both efficacy and toxicity. In highly selected breast cancer patients, stereotaxic radiotherapy demonstrates a very good local control with a low toxicity. With the purpose of improving the efficacy/toxicity ratio, we report the association of integrated boost with WBRT in a breast cancer patient with brain metastases. Two and a half years after completion of helical tomotherapy (HT), the patient experienced clinical and radiological complete remission of her brain disease. No delayed toxicity occurred and the patient kept her hair without need of radiosurgical procedure. The HT provided a high dosimetric homogeneity, delivering integrated radiation boosts, and avoiding critical structures involved in long-term neurological toxicity. Further assessment is required and recruitment of breast cancer patients into clinical trials is encouraged. 展开更多
关键词 brain METASTASES radiotherapy BREAST cancer TOMOTHERAPY
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Precision radiotherapy for brain tumors A 10-year bibliometric analysis 被引量:2
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作者 Ying Yan Zhanwen Guo +2 位作者 Haibo Zhang Ning Wang Ying Xu 《Neural Regeneration Research》 SCIE CAS CSCD 2012年第22期1752-1759,共8页
OBJECTIVE: Precision radiotherapy plays an important role in the management of brain tumors. This study aimed to identify global research trends in precision radiotherapy for brain tumors using a bibliometric analysi... OBJECTIVE: Precision radiotherapy plays an important role in the management of brain tumors. This study aimed to identify global research trends in precision radiotherapy for brain tumors using a bibliometric analysis of the Web of Science. DATA RETRIEVAL: We performed a bibliometric analysis of data retrievals for precision radiotherapy for brain tumors containing the key words cerebral tumor, brain tumor, intensity-modulated radiotherapy, stereotactic body radiation therapy, stereotactic ablative radiotherapy, imaging-guided radiotherapy, dose-guided radiotherapy, stereotactic brachytherapy, and stereotactic radiotherapy using the Web of Science. SELECTION CRITERIA: Inclusion criteria: (a) peer-reviewed articles on precision radiotherapy for brain tumors which were published and indexed in the Web of Science; (b) type of articles: original research articles and reviews; (c) year of publication: 2002-2011. Exclusion criteria: (a) articles that required manual searching or telephone access; (b) Corrected papers or book chapters. MAIN OUTCOME MEASURES: (1) Annual publication output; (2) distribution according to country; (3) distribution according to institution; (4) top cited publications; (5) distribution according to journals; and (6) comparison of study results on precision radiotherapy for brain tumors. RESULTS: The stereotactic radiotherapy, intensity-modulated radiotherapy, and imaging-guided radiotherapy are three major methods of precision radiotherapy for brain tumors. There were 260 research articles addressing precision radiotherapy for brain tumors found within the Web of Science. The USA published the most papers on precision radiotherapy for brain tumors, followed by Germany and France. European Synchrotron Radiation Facility, German Cancer Research Center and Heidelberg University were the most prolific research institutes for publications on precision radiotherapy for brain tumors. Among the top 13 research institutes publishing in this field, seven are in the USA, three are in Germany, two are in France, and there is one institute in India. Research interests including urology and nephrology, clinical neurology, as well as rehabilitation are involved in precision radiotherapy for brain tumors studies. CONCLUSION: Precision radiotherapy for brain tumors remains a highly active area of research and development. 展开更多
关键词 Cerebral tumor brain tumor intensity-modulated radiotherapy stereotactic body radiation therapy stereotactic ablative radiotherapy imaging-guided radiotherapy dose-guided radiotherapy stereotactic brachytherapy stereotactic radiotherapy
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Therapeutic Effect of First-line Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor (EGFR-TKI)Combined with Whole Brain Radiotherapy on Patients with EGFR Mutation-positive Lung Adenocarcinoma and Brain Metastases 被引量:1
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作者 Shao-bo KE Hu QIU +2 位作者 Jia-mei CHEN Wei SHI Yong-shun CHEN 《Current Medical Science》 SCIE CAS 2018年第6期1062-1068,共7页
This study compared the therapeutic effect of first-line epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)with that of EGFR-TKI plus whole brain radiotherapy(WBRT)on patients with EGFR mutation-posi... This study compared the therapeutic effect of first-line epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)with that of EGFR-TKI plus whole brain radiotherapy(WBRT)on patients with EGFR mutation-positive lung adenocarcinoma and brain metastases.A total of 139 patients with lung adenocarcinoma and brain metastases treated with first-line EGFR-TK1therapy from September 2008 to December 2017 were enrolled in this study.The study endpoints were intracranial time to progression(TTP)and overall survival(OS).The effects of clinical pathological parameters and EGFR gene status on the study endpoints were compared.The results showed that the intracranial TTP was significantly longer in EGFR-TKI plus WBRT group than in EGFR-TKI group (median 30.0 vs.18.2 months,χ2=10.824,P=0.001),but no significant difference in the OS was noted between the two groups (median 48.0 vs.41.1 months,χ2=0.012, P=0.912).Also,there was no statistically significant difference in the OS between patients treated with early and late radiotherapy (P=0.849)and between those with asymptomatic and those with symptomatic intracranial metastases (P=0.189).The OS and intracranial TTP of patients with intracranial oligometastases (≤3metastatic sites)were not significantly different from those of patients with multiple intracranial metastases (P=0.104 and P=0.357,respectively),and exon 19 and exon 21 mutations didn't show significant effects on the OS and intracranial TTP of patients (P=0.418 and P=0.386,respectively).In conclusion,there was no statistically significant difference in the OS between the EGFR-TKI alone group and EGFR-TK1 plus WBRT group.However, simultaneous use of WBRT was found to significantly prolong intracranial TTP and improve cerebral symptoms,and thus EGFR-TKI and WBRT combined may be clinically beneficial for patients with EGFR mutation-positive lung adenocarcinoma and brain metastases. 展开更多
关键词 lung ADENOCARCINOMA brain METASTASES EPIDERMAL growth factor receptor TYROSINE kinase inhibitor whole brain radiotherapy
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Radiotherapy for multiple brain metastases from hepatocellular carcinomas 被引量:1
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作者 Nobuyuki Toshikuni Kazuhiko Morii Michinori Yamamoto 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第33期4520-4522,共3页
A 78-year-old man with liver cirrhosis was found to have multiple hepatocellular carcinomas (HCCs) and underwent 3 sessions of transcatheter arterial chernoernbolization. Fourteen months after diagnosis, the patient... A 78-year-old man with liver cirrhosis was found to have multiple hepatocellular carcinomas (HCCs) and underwent 3 sessions of transcatheter arterial chernoernbolization. Fourteen months after diagnosis, the patient presented with left herniparesis. Contrast- enhanced magnetic resonance imaging showed multiple metastases with ring-shaped enhancement in the cerebrum and cerebellum. There were no metastases to other organs. The metastatic lesions almost completely disappeared after whole-brain radiotherapy with a total dose of 50 Gy. Neurologic symptoms decreased, and the patient's quality of life improved. The patient underwent 2 more sessions of transcatheter arterial chemoembolization. Twelve months after the diagnosis of brain metastasis, the patient remains alive. The present case indicates that radiotherapy can improve quality of life and prolong survival in some patients with brain metastases from HCCs. 展开更多
关键词 Hepatocellular carcinoma brain metastasis radiotherapy
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A Phase Ⅰ trial of dose escalation of topotecan combined with whole brain radiotherapy for brain metastasis in lung cancer 被引量:1
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作者 Xiaohui Ge Wenyan Zhao +5 位作者 Xiaocang Ren Yongqiang Wang Zhigang Li Yanqi Li Yuee Liu Qiang Lin 《The Chinese-German Journal of Clinical Oncology》 CAS 2012年第8期449-451,共3页
Objective The aim of this study was to define the maximum-tolerated dose (MTD) and observe the toxicity of escalating topotecan combined whole brain radiotherapy for brain metastasis in lung cancer.
关键词 brain metastasis neoplasm/lung cancer TOPOTECAN radiotherapy CHEMOTHERAPY maximum tolerated dose
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A CLINICAL STUDY FOR EVALUATING EARLY RADIOTHERAPY EFFECT IN PATIENTS WITH BRAIN TUMOR USING ^(99)Tc^m-HL91 SPECT
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作者 赵铭 张永学 +3 位作者 张承刚 兰胜民 王中敏 张秀甫 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2006年第3期222-228,共7页
Objective: The purpose of this study was to evaluate the early radiotherapy effect using ^99Tc^m-HL91 SPECT in patients with brain tumors. Methods: Twenty-one patients with brain tumors who were treated by radiother... Objective: The purpose of this study was to evaluate the early radiotherapy effect using ^99Tc^m-HL91 SPECT in patients with brain tumors. Methods: Twenty-one patients with brain tumors who were treated by radiotherapy were studied. KPS grade, tumor size on ^99Tc^m-HL91 SPECT, tumor size on MRI, and ratio of T/N (tumor counts/sec over normal brain tissue counts/sec) were investigated before ,during and after radiotherapy. Results: The average tumor size on ^99Tc^m-HL91 SPECT and MRI was 11.34±5.88 cm^2, 9.46±5.66 cm^2, respectively before radiotherapy. The tumor size on ^99Tc^m-HL91 SPECT was not in accordance with to that on MRI (P〈0.05). KPS grade, tumor size on ^99Tc^m-HL91 SPECT and ratio of T/N had significance differences before, during and after radiotherapy (P〈0.05), but the tumor size on MRI imaging had no significance differences before, during and after radiotherapy (P〉0.05). The rate of symptom improvement was 80% during radiotherapy and 100% after radiotherapy. The rates of imaging remission based on the brain tumor size on ^99Tc^m-HL91 SPECT, MRI and T/N were 75%, 15%, and 80%, respectively during radiotherapy. The agreement rates between imaging remission diagnosed by those three methods and symptom improvement were 70%, 40%, and 60% respectively during radiotherapy. The rates of imaging remission based on the brain tumor sizes on ^99Tc^m-HL91 SPECT, MRI and T/N were 100%, 25%, and 95% respectively after radiotherapy. The agreement rates between imaging remission diagnosed by those three methods and symptoms improvement were 100%, 20%, and 95% respectively after radiotherapy. Conclusion: The tumor size on ^99Tc^m-HL91 SPECT is a valuable tool for evaluating early radiotherapy effect of brain tumor in process of radiotherapy. T/N is not a feasible method in evaluating radiotherapy effect of brain tumor because it may show elevation unrelated to the curative effect during radiotherapy. 展开更多
关键词 Malignant brain tumor radiotherapy HYPOXIA ^99TC^M-HL91 SPECT.
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Therapeutic effect of concomitant treatment with temozolomide and radiotherapy on malignant brain glioma
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作者 Fan Zhao Yu Liao +5 位作者 Hai-feng Ji Jian-jun Chu Qing Sun Shu-bo Chen Qing Wang Wei-yang Ji 《中国现代医学杂志》 CAS CSCD 北大核心 2011年第3期365-370,共6页
关键词 malignant brain glioma radiotherapy TMZ VM-26 Me-CCNU survival
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Analyzing Planning Techniques for Whole Brain Radiotherapy
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作者 Soai Dang Quoc Quang Bui Vinh +2 位作者 Cuong Bui Xuan Toan Hoang Van Truong Vu 《International Journal of Medical Physics, Clinical Engineering and Radiation Oncology》 2020年第1期1-13,共13页
Aims: This study compares data between the Field in Field planning and Wedge planning techniques to figure out which technique has better dose coverage and distribution for PTV, and, if using FiF technique for whole b... Aims: This study compares data between the Field in Field planning and Wedge planning techniques to figure out which technique has better dose coverage and distribution for PTV, and, if using FiF technique for whole brain treatment, how many beams will have better plan. Methods: 56 patients, who need to radiate whole brain with 30 Gy/10 fractions, have been selected for this study. Four plans have been made for each patient (FiF1—one subfield per field plan, FiF2—two subfields per field plan, FiF3—three subfields per field plan, and a Wedge plan). Results: The results of Field in Field plans including Compare dose distribution on the transverse CT slice, plan evaluation using DVH, number MU of plan, Dmax, HI, HTCI, DmaxPTV, DmeanPTV. Volume of PTV with the dose over 105% prescribed dose, dose of organ at risk, and Quality Assurance (QA) plan, are better than those of Wedge plan. Conclusions: Plans using Field in Field technique has better coverage, is more homogeneous in dose distribution than plan using Wedge technique. When using Field in Field technique for whole brain radiotherapy, using three subfields per field has better result than two subfields per field and one subfield per field. 展开更多
关键词 FIELD in FIELD WHOLE brain radiotherapy HI HTCI GAMMA Index
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The effects of three-dimensional conformal radiotherapy combined with whole brain irradiation on brain metastases
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作者 Jin Hu Yeqing Zhou Mi Liu 《The Chinese-German Journal of Clinical Oncology》 CAS 2009年第3期172-174,共3页
Objective: To observe the recently therapeutic effects and toxicity of three-dimensional conformal radiotherapy combined with whole brain irradiation for patients with brain metastasis. Methods: 33 cases were treate... Objective: To observe the recently therapeutic effects and toxicity of three-dimensional conformal radiotherapy combined with whole brain irradiation for patients with brain metastasis. Methods: 33 cases were treated by whole brain irradiation at first, the dose of which was 36-40 Gy (18-20 f). Then three-dimensional conformal radiotherapy was added to the focus with a total dose of 20-25 Gy, whose fractionated dose was 2-5 Gy/time, 5 times/week or 3 times/week. Results: Within 1 month after radiotherapy, according to imaging of the brain, the CR of all patients was 45.5%, PR 36.4%, NC 15.1%, and PD 3%. For the 32 cases with neural symptoms before radiation, the CR of the symptoms was 40.6% and PR 59.4%. All patients gained different increases in KPS grade. By the end of the follow-up period, there were 22 deaths with the mean survival time up to 9.3 months. Conclusion: Three-dimensional conformal radiotherapy combined with whole brain irradiation can not only effectively control brain metastases and improve life quality, but also tends to prolong survival time. 展开更多
关键词 brain metastasis three-dimensional conformal radiotherapy whole brain irradiation EFFECT
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Efficacy and nursing of stereotactic radiotherapy in lung cancer patients with brain metastases
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作者 Xiaoxia Zhang Wenrong Yin Yueqin Liu 《The Chinese-German Journal of Clinical Oncology》 CAS 2008年第4期210-212,共3页
Objective: To observe the efficacy of stereotactic radiotherapy (SRT) in lung cancer patients with brain metas-tases and explore the nursing for those patients. Methods: From June 2002 to December 2006, 43 patients of... Objective: To observe the efficacy of stereotactic radiotherapy (SRT) in lung cancer patients with brain metas-tases and explore the nursing for those patients. Methods: From June 2002 to December 2006, 43 patients of lung cancer with brain metastases were treated with SRT, 8 of them were treated with the association of whole-brain radiotherapy (WBRT) and 6 of them were treated with combination of chemotherapy. During the period of SRT, the patients were applied with active psychological nursing and diet nursing. We also tried to prevent patients from epicranium injury, and meanwhile, patients were asked to took active convalesce exercise. Results: All patients finished SRT without serious reaction and complication. Local control rate was 81.4%, nervous system symptoms relief rate was 76.7% and KPS score was raised significantly. Survival time ranged from 2 to 34 months, median survival time was 8.5 months, and 6-month, 1-and 2-year survival rates were 58.9%, 26.2%, and 6.0% respectively. Conclusion: SRT was one of the effective palliation treatments for the lung cancer patients with brain metastases, and with the assistance of effective nursing, which would prolong their survival time and improved quality of life. 展开更多
关键词 lung cancer with brain metastases stereotactic radiotherapy (SRT) NURSING EFFICACY
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Efficacy of Temozolomide Combined with Whole Brain Radiotherapy in the Treatment of Cerebral Metastases from Lung Cancer
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作者 Lei ZHAO Ping SUN 《Medicinal Plant》 2017年第3期56-58,62,共4页
[Objectives] To observe the clinical efficacy,adverse reaction and survival time of temozolomide combined with whole brain radiotherapy in the treatment of lung cancer. [Methods] A total of 43 patients with lung cance... [Objectives] To observe the clinical efficacy,adverse reaction and survival time of temozolomide combined with whole brain radiotherapy in the treatment of lung cancer. [Methods] A total of 43 patients with lung cancer and cerebral metastases were reviewed and analyzed. Three-dimensional conformal radiotherapy(3D-CRT) technique was used to perform whole brain radiotherapy,one time a day and5 times a week. At the same time of radiotherapy,temozolomide chemotherapy was performed,150 mg/( m2·d),continuous oral administration of 5 d,every 28 days were a cycle( those patients who continue receiving temozolomide chemotherapy did not receive other related antitumor therapy,such as systemic chemotherapy and molecular targeted therapy,etc.),and drugs were administered for 4-6 cycles according to tolerance of patients. Kaplan-Meier method was used to calculate the survival rate. [Results]The objective response rate of 43 patients was79. 0%(34/43),in which CR was 6/43,PR was 28/43,and 9 cases had PD. By December 31,2016,7 patients in 43 cases died,one patient died of cerebral hernia due to intracranial lesions and 6 patients died of failure of other important organs due to metastasis. The OS and PFS of the whole group of patients in one year were 49. 1% and 56. 9% respectively. The adverse reactions were mild and the patients could tolerate such treatment. [Conclusions] Temozolomide combined with whole brain radiotherapy in the treatment of lung cancer with cerebral metastases has excellent clinical efficacy,while patients can tolerate such treatment. 展开更多
关键词 TEMOZOLOMIDE WHOLE brain radiotherapy Lung cancer CEREBRAL METASTASES
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Treatment of patients with multiple brain metastases by isolated radiosurgery:Toxicity and survival
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作者 AndréVinícius de Camargo Marcos Duarte de Mattos +4 位作者 Murilo Kenji Kawasaki Danilo Nascimento Salviano Gomes Allisson Bruno Barcelos Borges Vinicius de Lima Vazquez Raphael L C Araujo 《World Journal of Clinical Oncology》 2023年第10期400-408,共9页
BACKGROUND Radiosurgery for multiple brain metastases has been more reported recently without using whole-brain radiotherapy.Nevertheless,the sparsity of the data still claims more information about toxicity and survi... BACKGROUND Radiosurgery for multiple brain metastases has been more reported recently without using whole-brain radiotherapy.Nevertheless,the sparsity of the data still claims more information about toxicity and survival and their association with both dosimetric and geometric aspects of this treatment.AIM To assess the toxicity and survival outcome of radiosurgery in patients with multiple(four or more lesions)brain metastases.METHODS In a single institution,data were collected retrospectively from patients who underwent radiosurgery to treat brain metastases from diverse primary sites.Patients with 4-21 brain metastases were treated with a single fraction with a dose of 18 Gy or 20 Gy.The clinical variables collected were relevant to toxicity,survival,treatment response,planning,and dosimetric variables.The Spearman’s rank correlation coefficients,Mann-Whitney test,Kruskal-Wallis test,and Log-RESULTS From August 2017 to February 2020,55 patients were evaluated.Headache was the most common complaint(38.2%).The median overall survival(OS)for patients with karnofsky performance status(KPS)>70 was 8.9 mo,and this was 3.6 mo for those with KPS≤70(P=0.047).Patients with treated lesions had a median progression-free survival of 7.6 mo.There were no differences in OS(19.7 vs 9.5 mo)or progression-free survival(10.6 vs 6.3 mo)based on prior irradiation.There was no correlation found between reported toxicities and planning,dosimetric,and geometric variables,implying that no additional significant toxicity risks appear to be added to the treatment of multiple(four or more)lesions.CONCLUSION No associations were found between the evaluated toxicities and the planning dosimetric parameters,and no differences in survival rates were detected based on previous treatment status. 展开更多
关键词 RADIOSURGERY brain metastases radiotherapy SURVIVAL TOXICITY CANCER
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基于体素的分析方法比较IMRT与VMAT技术在晚期鼻咽癌患者大脑中的剂量差异 被引量:1
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作者 杜锋磊 杨一威 邵凯南 《中国医学物理学杂志》 CSCD 2024年第2期139-144,共6页
目的:定位晚期鼻咽癌患者放疗过程中大脑受照射的确切位置,分析IMRT和VMAT技术在晚期鼻咽癌患者的脑内剂量分布差异。方法:使用蒙特利尔神经学研究所空间中的CT脑模板,采用基于体素的分析方法对脑内的剂量分布进行分析。结果:对于晚期... 目的:定位晚期鼻咽癌患者放疗过程中大脑受照射的确切位置,分析IMRT和VMAT技术在晚期鼻咽癌患者的脑内剂量分布差异。方法:使用蒙特利尔神经学研究所空间中的CT脑模板,采用基于体素的分析方法对脑内的剂量分布进行分析。结果:对于晚期鼻咽癌患者,VMAT计划在保护脑内正常组织方面并没有表现出优势,相反,IMRT计划更加出色,IMRT计划表现出优势的区域包括脑干、小脑后叶、小脑前叶、颞叶、枕叶、边缘叶以及叶下回的部分区域。结论:对晚期鼻咽癌患者,VMAT在保护正常脑组织方面显示出劣势,提示IMRT方法对正常脑组织的保护可能更有优势。 展开更多
关键词 鼻咽癌 放射治疗 CT脑模板 剂量学
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均整器对海马规避全脑非均分调强放射治疗的剂量学影响
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作者 崔志强 董婷婷 +2 位作者 孙同友 郑艳杰 代俊利 《中国医学装备》 2024年第8期23-28,共6页
目的:研究非均分9野调强放疗均整过滤器(9F-IMRT-FF)和9野调强放疗非均整过滤器(9F-IMRT-FFF)两种模式下海马规避全脑放疗的剂量学差异。方法:选取2023年1-12月在承德市中心医院已完成全脑放疗的20例颅内转移患者的模拟定位CT图像,在计... 目的:研究非均分9野调强放疗均整过滤器(9F-IMRT-FF)和9野调强放疗非均整过滤器(9F-IMRT-FFF)两种模式下海马规避全脑放疗的剂量学差异。方法:选取2023年1-12月在承德市中心医院已完成全脑放疗的20例颅内转移患者的模拟定位CT图像,在计划系统中重新设计全新9F-IMRT-FF和9F-IMRT-FFF两种模式放疗计划。在两种模式优化参数保持一致的条件下进行放疗计划优化。比较两种模式计划的剂量学参数差异,以及加速器照射效率差异。结果:9F-IMRTFFF模式计划靶体积(PTV)的2%靶区体积的受照剂量(D_(2%))为(33.36±0.79)Gy,低于9F-IMRT-FF的(36.44±0.36)Gy,差异有统计学意义(t=-2.496,P<0.05)。9F-IMRT-FFF模式计划左侧海马的100%靶区体积的受照剂量(D_(100%))、最大剂量(D_(max))和平均剂量(D_(mean))均低于9F-IMRT-FF模式计划,差异有统计学意义(Z=-3.179、-3.018、-2.145,P<0.05)。9F-IMRT-FFF模式计划右侧海马D_(100%)、D_(max)低于9F-IMRT-FF模式计划,差异有统计学意义(Z=-3.099、-3.260,P<0.05)。9F-IMRT-FFF模式计划机器总跳数(MU)比9F-IMRT-FF模式计划增加25%,而治疗时间比9F-IMRT-FF模式缩短38%,差异有统计学意义(t=-9.664、-13.312,P<0.05)。结论:9F-IMRT-FF和9F-IMRT-FFF两种模式均能满足临床要求。9F-IMRT-FFF模式具备更佳的束流调制能力,对于降低海马放疗剂量、减少治疗时间和提高治疗效率更具有优势。 展开更多
关键词 调强放射治疗 非均整过滤器 海马规避全脑放疗 剂量学参数
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重组人血管内皮抑制素联合脑部放疗与单纯脑部放疗治疗实体肿瘤脑转移的疗效及预后
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作者 杨麒麟 魏敏 +4 位作者 杨霞 丁莉 张凯 王国红 黄懿 《中国实用神经疾病杂志》 2024年第8期990-997,共8页
目的探究重组人血管内皮抑制素(rh-Endostatin)联合脑部放疗(WBRT)与单纯WBRT治疗实体肿瘤脑转移的疗效及预后。方法回顾性分析2020-03—2022-11于资阳市人民医院肿瘤科治疗的94例患者的临床资料,根据治疗方式分为试验组和对照组,采用W... 目的探究重组人血管内皮抑制素(rh-Endostatin)联合脑部放疗(WBRT)与单纯WBRT治疗实体肿瘤脑转移的疗效及预后。方法回顾性分析2020-03—2022-11于资阳市人民医院肿瘤科治疗的94例患者的临床资料,根据治疗方式分为试验组和对照组,采用WBRT治疗的46例患者纳入对照组,采用rh-Endostatin联合WBRT治疗的48例患者纳入试验组,治疗结束1个月后比较临床疗效及肿瘤标志物指标[癌胚抗原(CEA)、癌抗原(CA125)、糖类抗原(CA19-9)、血管内皮生长因子(VEGFA、VEGFB、VEGFC)]、免疫功能(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、脑水肿体积和脑血流动力学参数(大脑前动脉平均血流速度和搏动指数)、生存质量[欧洲癌症研究治疗组织生命质量测定量表(EORTCQLQ)]、神经认知水平[简易精神状态量表(MMSE)],比较2组患者治疗期间放射性损伤,通过制作生存曲线分析患者预后情况。结果试验组患者治疗结束1个月时临床总有效率高于对照组(47.92%比26.09%),差异有统计学意义(P<0.05);2组患者治疗结束1个月时肿瘤标志物CEA、CA125、CA19-9、VEGFA、VEGFB、VEGFC水平,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平,脑水肿体积、搏动指数均较治疗前显著降低(P<0.05),试验组患者肿瘤标志物水平和脑水肿体积显著低于对照组患者(18.76±2.54比20.78±3.12,26.78±4.98比33.12±5.19,31.34±3.12比37.24±3.98,90.76±16.97比121.78±18.12,83.78±11.02比105.23±12.19,65.34±9.12比83.23±10.98,144.58±71.55比203.87±70.59),CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平显著升高(59.67±4.33比55.41±4.02,31.22±3.34比27.74±3.79,1.17±0.22比0.96±0.15),差异均有统计学意义(P<0.05);2组患者CD8^(+)水平、大脑前动脉平均血流速度、EORTC各维度评分和MMSE评分相较治疗前均明显升高(P<0.05),试验组患者CD8^(+)水平明显低于对照组(27.02±3.08比28.92±3.31),大脑前动脉平均血流速度(56.67±3.33比55.01±2.06)、EORTC各维度评分和MMSE评分(26.58±1.11比25.87±1.17)明显高于对照组,差异均有统计学意义(P<0.05);2组患者治疗期间均发生轻微放射性损伤,差异无统计学意义(P>0.05);治疗后试验组患者中位总生存期(OS)和颅内疾病无进展期(iPFS)均明显长于对照组患者(9.5比7.5,8.0比6.0),差异有统计学意义(P<0.05)。结论rh-Endostatin联合WBRT治疗实体肿瘤脑转移患者可有效改善近期疗效,抑制肿瘤进展,改善脑血流,维持认知功能及生存质量,保护免疫功能。该方案安全性良好,可一定程度上延长患者的OS和iPFS。 展开更多
关键词 脑转移瘤 实体肿瘤 重组人血管内皮抑制素 脑部放疗 脑转移 预后
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奥西替尼联合全脑放疗对非小细胞肺癌的疗效分析
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作者 侯志华 张莹 +1 位作者 魏红艳 魏晗 《河北医药》 CAS 2024年第17期2610-2613,共4页
目的探讨奥西替尼联合全脑放疗对非小细胞肺癌的治疗效果。方法选取2019年6月至2020年6月确诊为非小细胞肺癌并伴随脑转移的86例患者,随机数字表法分为试验组和对照组,每组43例。对照组采取常规化疗方式联合全脑放疗进行治疗,试验组在... 目的探讨奥西替尼联合全脑放疗对非小细胞肺癌的治疗效果。方法选取2019年6月至2020年6月确诊为非小细胞肺癌并伴随脑转移的86例患者,随机数字表法分为试验组和对照组,每组43例。对照组采取常规化疗方式联合全脑放疗进行治疗,试验组在常规化疗联合全脑放疗的基础上联合奥西替尼治疗,比较2组患者的近期疗效、血清肿瘤标志物含量、不良反应情况以及生存情况。结果试验组治疗有效率为88.4%高于对照组的62.8%(P<0.05)。试验组患者血清的CD4^(+)、CD8^(+)和CD4^(+)/CD8^(+)显著高于对照组(P<0.05);试验组的血清CYFRA21-1水平显著低于对照组(P<0.05)。试验组的患者的无病生存时间中位数为8个月,对照组为5个月,Log-rank检验显示,试验组的无病生存时间显著高于对照组(P<0.05)。结论奥西替尼联合全脑放疗作为治疗非小细胞肺癌脑转移患者的治疗方式,治疗效果较好,能延长患者的无病生存时间并且能提高患者的生存质量,值得临床推广应用。 展开更多
关键词 非小细胞肺癌 奥西替尼 全脑放疗
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三维适形放疗联合吡咯替尼对乳腺癌脑转移患者的疗效与安全性
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作者 王丹丹 亢春彦 +1 位作者 陈建中 宋宁宁 《中国实用神经疾病杂志》 2024年第11期1395-1399,共5页
目的探讨三维适形放疗(3D-CRT)与吡咯替尼联用对乳腺癌脑转移患者的治疗效果与安全性。方法回顾性选取2019-03—2024-03于郑州大学第二附属医院就诊的60例乳腺癌脑转移患者,按其是否服用吡咯替尼分为对照组和观察组,对比2组患者的治疗... 目的探讨三维适形放疗(3D-CRT)与吡咯替尼联用对乳腺癌脑转移患者的治疗效果与安全性。方法回顾性选取2019-03—2024-03于郑州大学第二附属医院就诊的60例乳腺癌脑转移患者,按其是否服用吡咯替尼分为对照组和观察组,对比2组患者的治疗效果、生存期、干预前后的血清同型半胱氨酸(Hcy)和ICAM-1水平、Karnofsky评分(KPS)和不良反应发生情况。结果观察组疗效优于对照组(66.66%比40.00%),且生存期更长(PFS:7.98±1.83比5.11±1.51;MS:11.55±1.59比8.17±1.84;OS:14.52±2.19比11.64±3.29;P<0.05)。观察组患者KSP评分改善更明显(80.00%比53.33%,P<0.05)。观察组Hcy(654.97±175.64比835.64±216.45)和ICAM-1(11.64±7.29比17.64±8.15)水平低于对照组(P<0.05)。2组不良反应对比无统计学差异(P>0.05)。结论3D-CRT结合吡咯替尼可提高乳腺癌脑转移患者的疗效和生活自理能力,延长生存期,且不会增加额外的治疗负担,安全性较高。 展开更多
关键词 脑转移瘤 乳腺癌 三维适形放疗 吡咯替尼 安全性
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