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Open Access Green as soon as Postprint is submitted to ZB.
HFSRT of the resection cavity in patients with brain metastases.
HFSRT der Resektionshöhle bei Patienten mit Hirnmetastasen.
Strahlenther. Onkol. 192, 368-376 (2016)
Purpose: Aim of this single center, retrospective study was to assess the efficacy and safety of linear accelerator-based hypofractionated stereotactic radiotherapy (HFSRT) to the resection cavity of brain metastases after surgical resection. Local control (LC), locoregional control (LRC = new brain metastases outside of the treatment volume), overall survival (OS) as well as acute and late toxicity were evaluated. Patients and methods: 46 patients with large (> 3 cm) or symptomatic brain metastases were treated with HFSRT. Median resection cavity volume was 14.16 cm3 (range 1.44–38.68 cm3) and median planning target volume (PTV) was 26.19 cm3 (range 3.45–63.97 cm3). Patients were treated with 35 Gy in 7 fractions prescribed to the 95–100 % isodose line in a stereotactic treatment setup. LC and LRC were assessed by follow-up magnetic resonance imaging. Results: The 1-year LC rate was 88 % and LRC was 48 %; 57% of all patients showed cranial progression after HFSRT (4% local, 44% locoregional, 9% local and locoregional). The median follow-up was 19 months; median OS for the whole cohort was 25 months. Tumor histology and recursive partitioning analysis score were significant predictors for OS. HFSRT was tolerated well without any severe acute side effects > grade 2 according to CTCAE criteria. Conclusion: HFSRT after surgical resection of brain metastases was tolerated well without any severe acute side effects and led to excellent LC and a favorable OS. Since more than half of the patients showed cranial progression after local irradiation of the resection cavity, close patient follow-up is warranted. A prospective evaluation in clinical trials is currently being performed.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Hypofractionated Stereotactic Radiotherapy ; Neoplasm Metastasis ; Quality Of Life ; Radiosurgery ; Survival; Postoperative Stereotactic Radiosurgery; Quality-of-life; Surgical Resection; Cerebral Metastases; Radiation-therapy; Intracranial Metastases; Prognostic-factors; Tumor-control; Radiotherapy; Cancer
ISSN (print) / ISBN
0179-7158
e-ISSN
1439-099X
Quellenangaben
Volume: 192,
Issue: 6,
Pages: 368-376
Publisher
Urban & Vogel
Publishing Place
Munich
Non-patent literature
Publications
Reviewing status
Peer reviewed
Institute(s)
Institute of Radiation Medicine (IRM)