脑转移瘤的放射治疗：ASCO指南与ASTRO指南共识

SCI

31 MAy 2022

Radiation Therapy for Brain Metastases: ASCO Guideline Endorsement of ASTRO Guideline

（J Clin Oncol；IF:44.544）

• Schiff D, Messersmith H, Brastianos PK, et al. Radiation Therapy for Brain Metastases: ASCO Guideline Endorsement of ASTRO Guideline [published online ahead of print, 2022 May 13]. J Clin Oncol. 2022

• CORRESPONDENCE TO : guidelines@asco.org.

Purpose 目的

American Society of Radiation Oncology (ASTRO) has developed a guideline on appropriate radiation therapy for brain metastases. ASCO has a policy and set of procedures for endorsing clinical practice guidelines that have been developed by other professional organizations.

American Society of Radiation Oncology (ASTRO) has developed a guideline on appropriate radiation therapy for brain metastases. ASCO has a policy and set of procedures for endorsing clinical practice guidelines that have been developed by other professional organizations.

Methods 方法

Radiation Therapy for Brain Metastases: An ASTRO Clinical Practice Guideline" was reviewed for developmental rigor by methodologists. An ASCO Endorsement Panel subsequently reviewed the content and the recommendations.

“脑转移的放射治疗：ASTRO 临床实践指南”制定的严谨程度由相关方法论专家进行审查。ASCO认证小组随后审查了指南中的相关内容和建议。

Results 结果

The ASCO Endorsement Panel determined that the recommendations from the ASTRO guideline, published May 6, 2022, are clear, thorough, and based upon the most relevant scientific evidence. ASCO endorses "Radiation Therapy for Brain Metastases: An ASTRO Clinical Practice Guideline."2.

ASCO认证小组确定，2022年5月6日发布的 ASTRO 指南中的建议清晰、全面，并存在相应的直接科学依据。ASCO支持“脑转移的放射治疗：ASTRO 临床实践指南”中的相关推荐。

Recommendations 推荐

Within the guideline, stereotactic radiosurgery (SRS) is recommended for patients with Eastern Cooperative Oncology Group performance status of 0-2 and up to four intact brain metastases, and conditionally recommended for patients with up to 10 intact brain metastases. The guideline provides detailed dosing and fractionation recommendations on the basis of the size of the metastases. For patients with resected brain metastases, radiation therapy (SRS or whole-brain radiation therapy [WBRT]) is recommended to improve intracranial disease control; if there are limited additional brain metastases, SRS is recommended over WBRT. For patients with favorable prognosis and brain metastases ineligible for surgery and/or SRS, WBRT is recommended with hippocampal avoidance where possible and the addition of memantine is recommended. For patients with brain metastases, limiting the single-fraction V12Gy to brain tissue to ≤ 10 cm3 is conditionally recommended.Additional information is available at www.asco.org/neurooncology-guidelines.

在指南中，立体定向放射外科（SRS）推荐用于东部肿瘤协作组体能状态为0-2分且最多存在4个完整脑转移瘤的患者，推荐视条件应用于最多10个完整脑转移瘤的患者。该指南根据转移灶的大小提供了详细的剂量和分级建议。对于切除脑转移瘤的患者，推荐放射治疗（SRS 或全脑放射治疗 [WBRT]）以改善颅内疾病控制；如果存在有限的额外脑转移，建议使用SRS而不是WBRT。对于预后良好且脑转移不适合手术和/或SRS的患者，建议在可能的情况下避免对海马体进行 WBRT，并建议添加美金刚治疗。对于脑转移患者，建议视条件将脑组织的单次V12Gy的照射剂量限制在 ≤ 10 cm3内。更多信息可在 www.asco.org/neurooncology-guidelines 获得。

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