X-knife radiosurgery in the treatment of brain metastasis of lung carcinoma / 中国微创外科杂志

ABSTRACT

Objective To discuss the X-knife radiosurgery (XKS) in the treatment of brain metastasis of lung carcinoma. Methods A total of 100 patients with similar prognostic factors were divided into two groups with 50 patients in each group, receiving either whole-brain radiotherapy alone (30~40 Gy/3~4 weeks) (Radiotherapy Group) or XKS combined with radiotherapy (Combination Group). In the Combination Group, 27 patients received XKS with single fraction of radiation, with a median prescription dose of 14.2 Gy, and the other 23 patients received multiple fractions of radiation (5~10 Gy/f, 3 times weekly), with a total dose of 15~30 Gy. Results In the Combination Group and the Radiotherapy Group, the median survival time was 16.4 and 10 months, respectively (P=0.0064), the 2-year local tumor control rate was 88% (44/50) and 44% (22/50), respectively (?2=21.569,P=0.000), and the effective rate under CT or MRI scanning at 1~3 months after treatment was 87.5% (35/40) and 52.2% (24/46), respectively (?2=16.497,P=0.001). An analysis on the cause of death showed that 11.9% of patients (5/42) in the Combination Group died from brain metastasis, which was significantly lower than that in the Radiotherapy Group (55.6%, 25/45) (?2=25.908,P=0.000). The incidence of complications was not significantly different between the Combination Group (8%, 4/50) and the Radiotherapy Group (4%, 2/50) (?2=0.709,P=0.400). Conclusions Combined use of X-knife radiosurgery and routine radiotherapy has better therapeutic effects than radiotherapy alone for treating brain metastatic tumor.