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Scharl, S.* ; Kessel, K.A. ; Diehl, C.* ; Gempt, J.* ; Meyer, B.* ; Zimmer, C.* ; Straube, C.* ; Combs, S.E.

Is local radiotherapy a viable option for patients with an opening of the ventricles during surgical resection of brain metastases?

Radiat. Oncol. 15:276 (2020)

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BACKGROUND: Local hypofractionated stereotactic radiotherapy (HFSRT) of the resection cavity is emerging as the standard of care in the treatment of patients with a limited number of brain metastases as it warrants less neurological impairment compared to whole brain radiotherapy. In periventricular metastases surgical resection can lead to an opening of the ventricles and subsequently carries a potential risk of cerebrospinal tumour cell dissemination. The aim of this study was to assess whether local radiotherapy of the resection cavity is viable in these cases. METHODS: From our institutional database we analyzed the data of 125 consecutive patients with resected brain metastases treated in our institution with HFSRT between 2009 and 2017. The incidence of LMD, overall survival (OS), local recurrence (LC) and distant recurrence were evaluated depending on ventricular opening (VO) during surgery. RESULTS: From all 125 patients, the ventricles were opened during surgery in 14 cases (11.2%). None of the patients with VO and 7 patients without VO during surgery developed LMD (p = 0.371). OS (p = 0.817), LC (p = 0.524) and distant recurrence (p = 0.488) did not differ in relation to VO during surgical resection. However, the incidence of distant intraventricular recurrence was slightly increased in patients with VO (14.3% vs. 2.7%, p < 0.01). CONCLUSION: VO during neurosurgical resection did not affect the outcome after HFSRT of the resection cavity in patients with brain metastases. Particularly, the incidence of LMD was not increased in patients receiving local HFSRT after VO. HFSRT can therefore be offered independently of VO as a local treatment of tumor bed after resection of brain metastases.

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Publication type Article: Journal article

Document type Scientific Article

Corresponding Author

Keywords Brain Metastases ; Hypofractionated Stereotactic Radiotherapy ; Leptomeningeal Disease ; Local Radiotherapy ; Ventricular Opening; Hypofractionated Stereotactic Radiotherapy; Leptomeningeal Metastasis; Radiation-therapy; Comparative Risk; Radiosurgery; Cavity; Multicenter; Disease; Bed

ISSN (print) / ISBN 1748-717X

e-ISSN 1748-717X

Journal Radiation Oncology

Quellenangaben Volume: 15, Issue: 1, Article Number: 276

Publisher BioMed Central

Publishing Place Campus, 4 Crinan St, London N1 9xw, England

Non-patent literature Publications

Reviewing status Peer reviewed

Institute(s) Institute of Radiation Medicine (IRM)

Grants Projekt DEAL