Perfil clínico dos pacientes submetidos à Radiocirurgia Estereotáxica como tratamento de Metástase Cerebral
DOI:
https://doi.org/10.63845/9pmxpe95Keywords:
Radiocirurgia estereotáxica. Metástases cerebrais. RadioterapiaAbstract
Este estudo objetiva avaliar o perfil sociodemográfico e clínico dos pacientes com metástase cerebral submetidos à radiocirurgia estereotáxica (RCE) no serviço de radioterapia de um hospital da região sul de Santa Catarina. Foram estudados dados de prontuários digitais de todos os pacientes submetidos à RCE como tratamento de metástase cerebral, de agosto de 2015 a agosto de 2016. Foram excluídos aqueles que realizaram RCE por outro motivo ou fora do período estudado. Dos 27 pacientes incluídos, 14 eram do sexo feminino e, 13, do masculino. O tumor primário mais encontrado foi o de pulmão (12 casos, 44,4%). A maioria dos pacientes apresentou uma lesão cerebral (16 casos, 59,3%), e a média de tamanho da lesão foi de 1,5 ± 0,86 cm. Em muitos pacientes a radiociurgia foi o único tratamento realizado para a metástase cerebral. Dos pacientes que haviam feito seguimento no hospital estudado (n = 14), nove apresentaram progressão da doença (64,3%), três obtiveram resposta parcial (21,4%) e dois permaneceram com doença estável (14,3%). A principal causa de progressão foi o aparecimento de novas lesões cerebrais (6 casos, 66,7%). A média de tamanho das lesões pós-radiocirurgia foi de 1,28 ± 0,57 cm. A diferença do tamanho médio das lesões pré e pós-radiciurgia foi de 0,22 cm (p = 0,593). Grande parte dos resultados encontrados é condizente com os dados já encontrados na literatura. Sugere-se que novos estudos sejam realizados no serviço, principalmente para avaliar a resposta à RCE.
References
Lin X, DeAngelis L. Treatment of Brain Metastases. Journal of Clinical Oncology. 2015;33(30):3475-3481. DOI: https://doi.org/10.1200/JCO.2015.60.9503
Radiosurgery Practice Guideline. Stereotactic Radiosurgery for Patients with Metastatic Brain Tumors. Brain Talk. 2008;5(2):1-24
Schüttrumpf L, Niyazi M, Nachbichler S, Manapov F, Jansen N, Siefert A et al. Prognostic factors for survival and radiation necrosis after stereotactic radiosurgery alone or in combination with whole brain radiation therapy for 1–3 cerebral metastases. Radiation Oncology. 2014;9(1):105. DOI: https://doi.org/10.1186/1748-717X-9-105
Barnett G, Linskey M, Adler J, Cozzens J, Friedman W, Heilbrun M et al. Stereotactic radiosurgery—an organized neurosurgery-sanctioned definition. Journal of Neurosurgery. 2007;106(1):1-5. DOI: https://doi.org/10.3171/jns.2007.106.1.1
Shiau C, Sneed P, Shu H, Lamborn K, McDermott M, Chang S et al. Radiosurgery for brain metastases: Relationship of dose and pattern of enhancement to local control. International Journal of Radiation Oncology*Biology*Physics. 1997;37(2):375-383. DOI: https://doi.org/10.1016/S0360-3016(96)00497-X
Suh J. Stereotactic Radiosurgery for the Management of Brain Metastases. New England Journal of Medicine. 2010;362(12):1119-1127. DOI: https://doi.org/10.1056/NEJMct0806951
Rodrigues G, Zindler J, Warner A, Lagerwaard F. Recursive Partitioning Analysis for the Prediction of Stereotactic Radiosurgery Brain Metastases Lesion Control. The Oncologist. 2013;18(3):330-335. DOI: https://doi.org/10.1634/theoncologist.2012-0316
Kickingereder P, Dorn F, Blau T, Schmidt M, Kocher M, Galldiks N et al. Differentiation of local tumor recurrence from radiation-induced changes after stereotactic radiosurgery for treatment of brain metastasis: case report and review of the literature. Radiation Oncology. 2013;8(1):52. DOI: https://doi.org/10.1186/1748-717X-8-52
Eisenhauer E, Therasse P, Bogaerts J, Schwartz L, Sargent D, Ford R et al. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). European Journal of Cancer. 2009;45(2):228-247. DOI: https://doi.org/10.1016/j.ejca.2008.10.026
Nieder C, Grosu A, Gaspar L. Stereotactic radiosurgery (SRS) for brain metastases: a systematic review. Radiation Oncology. 2014;9(1):155. DOI: https://doi.org/10.1186/1748-717X-9-155
Gorovets D, Ayala-Peacock D, Tybor D, Rava P, Ebner D, Cielo D et al. Multi-institutional Nomogram Predicting Survival Free From Salvage Whole Brain Radiation After Radiosurgery in Patients With Brain Metastases. International Journal of Radiation Oncology*Biology*Physics. 2017;97(2):246-253. DOI: https://doi.org/10.1016/j.ijrobp.2016.09.043
Brown D, Lanciano R, Heal C, Hanlon A, Yang J, Feng J et al. The effect of whole-brain radiation (WBI) and Karnofsky performance status (KPS) on survival of patients receiving stereotactic radiosurgery (SRS) for second brain metastatic event. Journal of Radiation Oncology. 2016;6(1):31-37. DOI: https://doi.org/10.1007/s13566-016-0287-y
Shaw E, Scott C, Souhami L, Dinapoli R, Kline R, Loeffler J et al. Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: final report of RTOG protocol 90-05. International Journal of Radiation Oncology*Biology*Physics. 2000;47(2):291-298. DOI: https://doi.org/10.1016/S0360-3016(99)00507-6
Murray L, Menard C, Zadeh G, Au K, Bernstein M, Millar B et al. Radiosurgery for brainstem metastases with and without whole brain radiotherapy: clinical series and literature review. Journal of Radiation Oncology. 2016;6(1):21-30. DOI: https://doi.org/10.1007/s13566-016-0281-4
L. Kasper D, L. Hauser S, Jameson J, S. Fauci A, L. Longo D, Loscalzo J. Harrison's principles of internal medicine. 19th ed. New York: McGraw-Hill Global Education Holdings; 2015.
Rades D, Huttenlocher S, Hornung D, Blanck O, Schild S, Fischer D. Do patients with very few brain metastases from breast cancer benefit from whole-brain radiotherapy in addition to radiosurgery?. Radiation Oncology. 2014;9(1):267. DOI: https://doi.org/10.1186/s13014-014-0267-6
Chougule P, Burton-Williams M, Saris S, Zheng Z, Ponte B, Noren G et al. Randomized treatment of brain metastasis with gamma knife radiosurgery, whole brain radiotherapy or both. International Journal of Radiation Oncology*Biology*Physics. 2000;48(3):114. DOI: https://doi.org/10.1016/S0360-3016(00)80024-3
Downloads
Published
Issue
Section
License
Copyright (c) 2018 Arquivos Catarinenses de Medicina
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
