| Objective:The small cell lung cancer(SCLC)grows fast,which has a high degree of malignancy,and is prone to brain metastases(BM).Currently,radiotherapy has always been the main treatment for tumor brain metastasis.This study aims to determine the local control,intracranial recurrence and patient prognosis of the WBRT + SIB,and explore the safety and feasibility of this treatment model.Methods:A retrospective review of 33 patients of SCLC with BM diagnosed and treated in the Department of Radiotherapy,the First Hospital of Jilin University from June,2016 to June,2019 was conducted.The data were retrieved according to the items including age,sex,tumor numbers of BM,the radiotherapy clinical manifestations before treatment and other items.The intracranial recurrence,side effects and intracranial progression-free survival(IPFS)were systematically analyzed.Results:A total of 33 patients were included in this study,and the average age at the time of diagnosis of BM was 60.93 years old(42-75 years old),including 16 cases(48.48%)≤ 60 years old and 17 cases(51.52%)> 60 years old.The average number of brain metastases was 2.48(1-8),the number of BM with 1-3 were 24(72.72%)cases,while the number of BM more than 3 were 9 cases(27.28%).After receiving radiotherapy with WBRT + SIB mode,2 cases were evaluated as complete response(CR);23 cases(69.70%)were evaluated as partial remission(PR);2 cases(6.06%)were evaluated as stable disease(SD);6 cases(15.15%)relapsed or died,including 1case(3.03%)relapsed and 5 cases(15.15%)died,and the efficacy evaluation was disease progression(PD).The objective response rate(ORR)was 75.76%,and thelocal control rate(LCR)was 81.82%.The patients had good tolerance during the treatment.The main adverse events related to the treatment were grade 0-2,and no grade 3 or above adverse reactions were found.The most common side effects were alopecia(30.30%).Dizziness(15.15%)was the most common adverse reaction of nervous system(15.15%),and headache,nausea and vomiting could be observed in the rest of the patients which were relieved after receiving symptomatic treatment.No long-term adverse reactions of the nervous system caused by radiotherapy,such as cognitive impairment and memory loss were observed.The median IPFS was 10 months.Age was an important factor,and the median IPFS of the patients with age ≤60 years old was longer than that of patients with age > 60 years old(10.5 vs 8.5months,P < 0.05).The number of BM was another important factor,and the patients with 1-3 BM had longer IPFS than the patients with more than 3 BM(10.0 vs 9.0months,P < 0.05).Conclusion:The radiotherapy mode of WBRT + SIB has a high local control rate and is able to prolong the survival period of the patients with brain metastasis of SCLC.It has a good safety and short treatment time and can be utilized as the optimal scheme for the patients with brain metastasis of SCLC.Age > 60 years old and the number of brain metastases > 3 in the patients are poor prognostic factors. |
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