Effect of whole-brain radiotherapy combined with simultaneous integrated boost radiotherapy for metastatic lesions in the treatment of patients with brain metastases
Niu Leilei
Lu Feng
Liu Yuping
Wang Yu
Li Taiping
Abstract：Objective To analyze the effect of whole-brain radiotherapy(WBRT)combined with simultaneous integrated boost(SIB)radiotherapy for metastatic lesions in the treatment of patients with brain metastases(BM),and the impact on serum carcinoembryonic antigen(CEA),neuron-specific enolase(NSE)and cytokeratin 19 fragments(CYFRA21-1).Methods Clinical data of 106 patients with multiple BM who were admitted to our hospital from May 2020 to September 2023 were retrospectively analyzed.According to different treatment plans,they were assigned to the combination group(51 cases receiving WBRT and SIB radiotherapy for metastatic lesions)and the control group(55 cases receiving WBRT).The two groups were compared in terms of biochemical indicators(CEA,NSE,and CYFRA21-1),dosimetric parameters,clinical indices(maximum lesion diameter,lesion count,and number of intratumoral vessels),short-term efficacy,survival status,and adverse reactions.Results After treatment,CEA,NSE and CYFRA21-1 levels in the combination group were lower than those in the control group(t=3.920,4.600,5.390,P＜0.05).Conformity index and homogeneity index of the combination group were larger(t=3.292,8.778,P＜0.05).The prescribed dose to target volume ratio of the combination group was smaller(t=3.217,P＜0.05).The maximum lesion diameter and number of intratumoral vessels in the combination group were smaller(t=3.257,3.179,P＜0.05).The number of lesions was comparable between the two groups after treatment(t=1.737,P=0.085).ORR and DCR of the combination group were higher(x2=7.435,8.589,P＜0.05).The one-year overall survival rate of the combination group(80.39％)was higher than that of the control group(52.73％)(log-rankx2=10.894,P＜0.05).Adverse reactions showed no statistically significant differences between the groups(Z=1.147,0.263,0.305,P＞0.05).Conclusion Compared with WBRT alone,WBRT combined with SIB radiotherapy for metastatic lesions can effectively lower serum CEA,NSE and CYFRA21-1 levels in patients with BM,enhance local control effect and short-term efficacy,and contribute to the improvement of prognosis,with good dosimetric advantages and without significant increase in adverse reactions.
Keywords：Whole-brain radiotherapySimultaneous integrated boost radiotherapyBrain metastasisCarcinoembryonic antigenNeuron-specific enolase
Publication Date：2025-08-31
Online Publishing Date：2025-09-24(First online date of this platform, not the publication date of the document)
Pages：5( 597-601 )