BACKGROUND: Brain metastases represent the most common intracranial tumors and are associated with very poor prognosis. OBJECTIVE: To investigate the feasibility, survival, and cerebral disease control of patients with singular brain metastases treated with stereotactic 125iodine brachytherapy (SBT), to identify prognostic factors, and to compare results with other local treatment methods. METHODS: Complications, survival (overall and separated by recursive partitioning analysis [RPA] classes), and local and distant disease control were evaluated retrospectively in 90 patients. Prognostic factors were identified by forming subgroups of patients based on age, Karnofsky Performance Status, status of extracranial disease, interval since initial diagnosis, absence/presence of prior whole-brain radiation therapy, localization, morphology, and tumor volume. RESULTS: There was no treatment-related mortality, and morbidity was transient and low (3.3%). Median survival was 8.5 months overall and 18.1 months for RPA class 1 patients. After 1 year, the actuarial incidence of local and distant cerebral relapse was 5.4% and 46.4%, respectively. Karnofsky Performance Status ≥ 70 (P < .002), stable systemic disease (P < .02), RPA class 1 (P < .02), and a prolonged (> 12 month) interval between initial diagnosis and SBT (P < .05) significantly improved survival. No significant influence of previous whole-brain radiation therapy on survival or cerebral disease relapse was found. CONCLUSION: SBT represents a safe, minimally invasive, and, compared with SRS and microsurgery, a similarly effective local treatment option in terms of survival and cerebral disease control. It allows histological (re-)evaluation and treatment within 1 stereotactic operation. Because it is less restricted by tumor localization or size, it greatly advances local treatment options, and on the basis of its favorable biological irradiation effect, SBT does not limit additional irradiation treatment in the event of disease relapse.
BACKGROUND: Brain metastases represent the most common intracranial tumors and are associated with very poor prognosis. OBJECTIVE: To investigate the feasibility, survival, and cerebral disease control of patients with singular brain metastases treated with stereotactic 125iodine brachytherapy (SBT), to identify prognostic factors, and to compare results with other local treatment methods. METHODS: Complications, survival (overall and separated by recursive partitioning analysis [RPA] classes), and local and distant disease control were evaluated retrospectively in 90 patients. Prognostic factors were identified by forming subgroups of patients based on age, Karnofsky Performance Status, status of extracranial disease, interval since initial diagnosis, absence/presence of prior whole-brain radiation therapy, localization, morphology, and tumor volume. RESULTS: There was no treatment-related mortality, and morbidity was transient and low (3.3%). Median survival was 8.5 months overall and 18.1 months for RPA class 1 patients. After 1 year, the actuarial incidence of local and distant cerebral relapse was 5.4% and 46.4%, respectively. Karnofsky Performance Status ≥ 70 (P < .002), stable systemic disease (P < .02), RPA class 1 (P < .02), and a prolonged (> 12 month) interval between initial diagnosis and SBT (P < .05) significantly improved survival. No significant influence of previous whole-brain radiation therapy on survival or cerebral disease relapse was found. CONCLUSION: SBT represents a safe, minimally invasive, and, compared with SRS and microsurgery, a similarly effective local treatment option in terms of survival and cerebral disease control. It allows histological (re-)evaluation and treatment within 1 stereotactic operation. Because it is less restricted by tumor localization or size, it greatly advances local treatment options, and on the basis of its favorable biological irradiation effect, SBT does not limit additional irradiation treatment in the event of disease relapse.
Authors: Stephanie G Kellermann; Christina A Hamisch; Daniel Rueß; Tobias Blau; Roland Goldbrunner; Harald Treuer; Stefan J Grau; Maximilian I Ruge Journal: J Neurooncol Date: 2017-06-21 Impact factor: 4.130
Authors: Philipp Kickingereder; Christina Hamisch; Bogdana Suchorska; Norbert Galldiks; Veerle Visser-Vandewalle; Roland Goldbrunner; Martin Kocher; Harald Treuer; Juergen Voges; Maximilian I Ruge Journal: J Neurooncol Date: 2014-08-24 Impact factor: 4.130
Authors: Maximilian I Ruge; Philipp Kickingereder; Stefan Grau; Mauritius Hoevels; Harald Treuer; Volker Sturm Journal: J Neurooncol Date: 2011-04-11 Impact factor: 4.130
Authors: Maximilian I Ruge; Philipp Kickingereder; Stefan Grau; Franziska Dorn; Norbert Galldiks; Harald Treuer; Volker Sturm Journal: Neuro Oncol Date: 2013-09-17 Impact factor: 12.300
Authors: Michael A Mooney; Wenya Linda Bi; Jonathan M Cantalino; Kyle C Wu; Thomas C Harris; Lucas L Possatti; Parikshit Juvekar; Liangge Hsu; Ian F Dunn; Ossama Al-Mefty; Phillip M Devlin Journal: J Neurooncol Date: 2019-11-19 Impact factor: 4.130
Authors: Maximilian I Ruge; Philipp Kickingereder; Thorsten Simon; Harald Treuer; Volker Sturm Journal: J Neurooncol Date: 2012-05-12 Impact factor: 4.130
Authors: Maximilian I Ruge; Philipp Kickingereder; Stefan Grau; Harald Treuer; Volker Sturm; Juergen Voges Journal: Radiat Oncol Date: 2012-06-19 Impact factor: 3.481