Purpose: The aim of the present retrospective study was to report outcomes after hypofractionated stereotactic radiotherapy (HSRT) for resected brain metastases (BM).
Patients And Methods: We reviewed results of patients with resected BM treated with postoperative HSRT (3×7.7Gy to the prescription isodose 70%) between May 2013 and June 2020. Local control (LC), distant brain control (DBC), overall survival (OS), leptomeningeal disease relapse (LMDR), and radiation necrosis (RN) occurrence were reported.
Results: Twenty-two patients with 23 brain cavities were included. Karnofsky Performance status (KPS) was≥70 in 77.3%. Median preoperative diameter was 37mm [21.0-75.0] and median planning target volume (PTV) was 23 cm [9.9-61.6]. Median time from surgery to SRT was 69 days [7-101] and 48% of patients had a local relapse on pre-SRT imaging. Median follow-up was 17.5 months [1.6-95.9]. One and two-year LC rates were 60.9 and 52.2% respectively. One and 2-year DBC rates were 45.5 and 40.9%. Median OS was 16.5 months. Four patients (18.2%) presented LMDR during follow-up. RN occurred in 6 patients (27.2%). Three factors were associated with OS: ECOG-PS (P=0.009), KPS (P=0.04), cystic or solid nature of the metastasis before surgery (P=0.037). Several factors were related to RN occurrence: PTV diameter and volume, Normal brain V21, V21 and V24 isodoses volumes.
Conclusion: HSRT is the most widely used scheme for larger brain cavities after surgery. The optimal dose and scheme remain to be defined as well as the optimal delay between postoperative SRT and surgery. Dose escalation may be necessary, especially in case of subtotal resection.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.canrad.2022.07.006 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Age Is Just a Number? A Retrospective Review of Cause of Death in Patients 85 Years and Over Receiving Lung Stereotactic Ablative Radiotherapy.
J Med Imaging Radiat Oncol
January 2025
Icon Cancer Centre Gold Coast University Hospital, Southport, Queensland, Australia.
Introduction: Patients aged > 85 years are under-represented in research that has established stereotactic body radiotherapy (SBRT) as the standard of care in early stage non-small cell lung cancer (NSCLC) not suitable for or refusing surgery. With an ageing population in Australia, it is important to assess SBRT and cause of death (COD) in elderly patients receiving curative intent lung SBRT.
Methods: This is a multi-centre retrospective review of eligible patients treated across Australia from 2016 to 2022 with curative intent lung SBRT for early stage primary NSCLC, and aged 85 years or over.
Cost-minimization analysis of the GORTEC 2014-04 randomized phase II study of stereotactic ablative radiotherapy (SABR) or chemotherapy-SABR in oligometastatic head and neck cancer.
Radiother Oncol
January 2025
GORTEC 4 bis rue Emile Zola 37000 Tours, France; Department of Radiotherapy, Centre François-Baclesse, Corpuscular Physics Laboratory, IN2P3, ENSICAEN, CNRS UMR 6534, Université de Normandie, Caen, France. Electronic address:
Purpose: The randomized phase II GORTEC 2014-04 and French Head and Neck Intergroup study showed deeper deterioration of the quality of life (HRQoL) and dramatically higher severe toxicity rates with similar overall survival rates using chemo-SABR compared to SABR alone in oligometastatic head and neck cancer (HNSCC) patients. We evaluated the costs associated with SABR-alone versus chemo-SABR and their associated costs (transportation, hospitalizations, etc).
Materials And Methods: 69 HNSCC patients with 1-3 oligometastases and a controlled primary were randomized from September 2015 to October 2022.
Long-Term Hearing Preservation After Radiosurgery for Vestibular Schwannoma.
World Neurosurg
January 2025
Departments of Neurosurgery, Los Angeles, California, USA; Radiation Oncology, Los Angeles, California, USA; Head and Neck Surgery, Los Angeles, California, USA; Jonsson Comprehensive Cancer Center, Los Angeles, California, USA; Los Angeles Biomedical Research Institute, Los Angeles, California, USA; Harbor-UCLA Medical Center, Los Angeles, California, USA.
Efficacy and safety of laser interstitial thermal therapy versus radiofrequency ablation and stereotactic radiosurgery in the treatment of intractable mesial temporal lobe epilepsy: a systematic review and meta-analysis.
Neurosurg Rev
January 2025
Department of neurosurgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Epilepsy is a common neurological disease that is treated with medications; however, patients with drug-resistant epilepsy, commonly intractable temporal lobe epilepsy, tend to have better control with surgical treatment. While the mainstay of surgical treatment is anterior temporal lobectomy, it carries risk of potential adverse effects hence minimally invasive techniques are now being used as an alternative to open surgery. This systematic review and meta-analysis compare the efficacy and safety of three of the most used techniques: laser interstitial thermal therapy (LITT), radiofrequency ablation (RFA) and stereotactic radiosurgery (SRS).
View Article and Find Full Text PDFRoles of SPOCK1 in the Formation Mechanisms and Treatment of Non-Small-Cell Lung Cancer and Brain Metastases from Lung Cancer.
Onco Targets Ther
January 2025
Department of Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China.
Lung cancer is a malignant tumor with high morbidity and mortality in China and worldwide. Once it metastasizes to the brain, its prognosis is very poor. Brain metastases are found in about 20% of newly diagnosed non-small-cell lung cancer (NSCLC) patients.
View Article and Find Full Text PDFWant 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!