脑部放疗，上午比下午敏感许多！
+ ^* } e( Q8 \, J% X% `9 i$ B9 n* y9 V+ N4 H# G
" ~& M1 L! Q5 C6 Z
Cancer 2011 Jan 15;117(2):414-20. doi: 10.1002/cncr.25423. Epub 2010 Sep 9.
8 N5 }6 ?( h% ?2 n9 [Gamma knife radiosurgery for brain metastasis of nonsmall cell lung cancer: is there a difference in outcome between morning and afternoon treatment?2 L! F, ~& q/ Y3 H/ N- I
Rahn DA 3rd, Ray DK, Schlesinger DJ, Steiner L, Sheehan JP, O'Quigley JM, Rich T.0 l7 D: P) L5 u \+ j: i6 u
SourceDepartment of Radiation Oncology, University of Virginia Health Sciences Center, Charlottesville, Virginia 22908, USA.
5 w t0 f2 d' P3 _, ~( o3 F9 a) g; t2 T
Abstract7 j( a( M0 e0 S3 [( ^
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.
9 z( w) j4 a+ v9 |% t: r
3 M2 X: Z/ ^9 u8 W1 aMETHODS: 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.
7 m9 Z, [3 U$ Y
; V1 T9 \+ S0 ^RESULTS: 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).1 n0 C6 | s2 B
b, V8 m, \( R( 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.
% F+ _$ G8 n' _. G" ?8 [$ a" N
7 k. Z8 \3 v! F# M/ x$ t |
) d( T i0 K0 u, a K- H! ]
显身卡
