Objectives Brain metastases (BM) are the most common intracranial tumors in adults. Surgery and frame-based stereotactic radiosurgery (SRS) are well-described treatment options. Frameless SRS is an emerging BM treatment option offering fewer side effects. The aim of this study was to describe the therapeutic outcomes and toxicity of frameless SRS with linear accelerator (LINAC)-based technology for BM treatment in our institution. Materials and methods We performed a retrospective study including all adult patients treated with frameless SRS with LINAC-based technology for BM between October 2010 and July 2016. Patients were followed routinely with MRI scans at three-month intervals. Primary endpoints were progression-free survival, local control, overall survival, and toxicity related to the treatment. All survival times were computed with the Kaplan-Meier method. All cumulative incidences were computed using competing risk analyses. Results A total of 194 metastatic lesions in 141 patients were treated in a 69-month interval. At the time of analysis, 33 patients were still alive, with a median follow-up time of 25.1 months. The overall median survival was 8.7 months. The median progression-free survival was 5.3 months. Local recurrence as a first event was 25% and 38% at one and two years, respectively, while distant brain recurrence as a first event was 18% and 21%. Death before any brain event occurred in 31% of patients. The cumulative incidence of radiation necrosis as a first brain event was 2% at one and two years. Conclusions The treatment of BM with LINAC-based frameless SRS in our institution had an overall and progression-free survival comparable with the literature for frameless SRS and for conventional frame-based SRS while being less invasive and more comfortable for the patient. In our study, frameless SRS with LINAC technology seems to be safe for BM treatment with minimal rates of radiation necrosis.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8259533PMC
http://dx.doi.org/10.7759/cureus.15475DOI Listing

Publication Analysis

Top Keywords

frameless srs
24
linac-based technology
12
progression-free survival
12
stereotactic radiosurgery
8
linear accelerator
8
accelerator linac-based
8
brain metastases
8
141 patients
8
srs
8
months median
8

Similar Publications

Background: Brain metastases are the most common intracranial malignancy and remain a substantial source of morbidity and mortality in cancer patients. Linear accelerator based stereotactic radiosurgery (SRS) is widely used and is frequently delivered by hypo-fractionnated volumetric modulated arc therapy using non-coplanar beams, where geometric accuracy and planning margins are a major concern.

Purpose: To give a practical analysis of intrafraction patient motion for multi-target, single isocentre, brain SRS treatments and to derive adapted GTV-to-PTV margins.

View Article and Find Full Text PDF

Purpose: The aim of this study was to assess the accuracy of a surface-guided radiotherapy (SGRT) system for setup and intra-fraction motion control in frameless non-coplanar stereotactic radiosurgery (fSRS) using actual patient data immobilized with two different types of open-faced masks and employing a novel SGRT systems settings.

Methods And Materials: Forty-four SRS patients were immobilized with two types of open-faced masks. Sixty lesions were treated, involving the analysis of 68 cone-beam scans (CBCT), 157 megavoltage (MV) images, and 521 SGRT monitoring sessions.

View Article and Find Full Text PDF
Article Synopsis
  • The study looked at patients with brain tumors caused by colorectal cancer to see how to better treat and watch them.
  • Researchers wanted to find out what factors could help predict how long patients might live and how their tumors might grow after treatment with a specific therapy called stereotactic radiosurgery (SRS).
  • The results showed that many patients with these brain tumors also have other cancer spreading in their body, and certain genetic changes in their tumors can help understand how their health might change after treatment.
View Article and Find Full Text PDF
Article Synopsis
  • Stereotactic Radiosurgery (SRS) is a technique that focuses high doses of radiation on specific brain areas while protecting surrounding healthy tissue; this study compares the traditional frame-based method to a newer frameless approach for treating brain metastases.
  • The research followed systematic review protocols and analyzed 499 studies, narrowing it down to 35 for detailed data assessment, yielding promising overall survival and local control rates for patients undergoing frameless SRS.
  • The meta-analysis demonstrated that frameless SRS effectively improves survival and local control for brain metastasis patients, with significant rates such as a 75% 6-month overall survival rate and a 93% local control rate after 6 months.*
View Article and Find Full Text PDF

Impact of Fractionation Regimen on Local Control Following Frameless Linear Accelerator-Based Image-Guided Stereotactic Radiosurgery and Radiotherapy for Intracranial Meningioma.

World Neurosurg

October 2024

Department of Radiation Oncology, Southern California Permanente Medical Group, Los Angeles, California, USA; Department of Clinical Sciences, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA. Electronic address:

Objective: Stereotactic radiosurgery (SRS) is an established treatment for intracranial meningioma, yet this approach is often precluded by tumor size or proximity to critical structures. Fractionated radiotherapy (RT) may be employed to address these limitations. We performed a comparison of local control (LC) outcomes between 3 stereotactic techniques.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!