FIGURE 1.

FIGURE 2.

FIGURE 3.

FIGURE 4.

Risk factors of TLC for LBM in motor area after ‘Sandwich treatment’
Univariate analysis | Multivariate analysis | |||||
---|---|---|---|---|---|---|
HR ratio | 95%CI | P-value | HR ratio | 95%CI | P-value | |
Age | 0.978 | (0.598–1.686) | 0.697 | |||
>=62 | ||||||
<62 | ||||||
Sex | 1.678 | (0.913–2.174) | 0.781 | |||
Male | ||||||
Female | ||||||
Primary tumor | ||||||
Lung/Breast | 0.459 | (0.359–0.898) | < 0.01 | 0.539 | (0.339–0.812) | 0.007 |
Lung/GL tract | 0.913 | (0.478–1.316) | < 0.01 | 0.784 | (0.498–0.987) | 0.006 |
Breast/Gl tract | 1.987 | (0.878–1.974) | 0.411 | |||
KPS score | 2.113 | (1.159–6.733) | 0.139 | |||
>= 60 | ||||||
<60 | ||||||
Total tumor volume | 0.719 | (0.419–1.598) | 0.211 | |||
>=20.1cm3 | ||||||
<20.1cm3 | ||||||
Peri-tumor edema volume | 1.589 | (0.973–2.894) | 0.566 | |||
>=12.6cm3 | ||||||
<12.6cm3 | ||||||
Dose at first-stage SRS | 1.325 | (0.53–1.734) | 0.989 | |||
>= 13.0 Gy | ||||||
< 13.0 Gy | ||||||
Dose at second-stage SRS | 0.845 | (0.356–1.250) | 0.593 | |||
>= 12.5 Gy | ||||||
< 12.5 Gy |
Comparison between ‘Sandwich treatment’ and other reports of 2-SSRS strategy for BM
Author | Year | Case number | Median diameter/volume of BM | Total dose | 2-SSRS interval | 6 Months OS/median OS | 6 Months TLC/median TLC | Radiation necrosis |
---|---|---|---|---|---|---|---|---|
Yomo et al.9 | 2012 | 27 | 17.8 cm3 | 27 Gy | 3−4 weeks | 8.8 months | 89.8% | 11.1% |
Yomo and Hayashi29 | 2014 | 58 | 16.4 cm3 | 28 Gy | 3−4 weeks | 63% | 85.0% | 8.6% |
Angelov et al.10 | 2018 | 54 | Diameter>=2cm | 30 Gy | 34 days | 65% | 88.0% | 11.0% |
Dohm et al.8 | 2018 | 33 | LBM | 29 Gy | 30 days | 65% | 96.8% | 6.06% |
Hori et al.31 | 2020 | 181 | 4 cm3 | N/A | N/A | 14.6 months | 91.0% | N/A |
Ito et al.32 | 2020 | 178 | 10 cm3 | 26 Gy | 7−38 days | 6.6 months | 93.2% | 6.20% |
Damron et al.30 | 2022 | 24 | 8.1 cm3 | 30 Gy | 32 days | 9.1months | 80% | N/A |
Cho et al.33 | 2022 | 142 | Median 7.4 cm3 | 27−28 Gy | 32 days | 14 months | 88−90% | 17% |
Present study | 2023 | 51 | 20.1 cm3 | 25.5 Gy | 7 days | 91.8%, 14 months | 93.4% | 13.11% |
Patient characteristics
Characteristic | Value | Range |
---|---|---|
Age(median, years) | 62 | 34–81 |
Sex | ||
Female | 36 | |
Male | 25 | |
Primary tumor | ||
Lung | 39 | |
Breast | 13 | |
Gastric-intestinal tract | 9 | |
KPS (median) | 60 | 50 –80 |
Dose at first-stage SRS (median, Gy) | 13.0 | 11–15 |
Dose at second-stage SRS (median, Gy) | 12.5 | 11–14 |
Total tumor volume (mean, cm3) | 20.1 | 17.2–29.7 |
Peri-tumor edema volume (mean, cm3) | 12.6 | 4.9–19.6 |
Follow-up time (median, months) | 18.3 | 6.3–47.9 |