BACKGROUND: Tumor bed stereotactic radiosurgery (SRS) after resection of brain metastases is a new strategy to delay or avoid whole-brain irradiation (WBRT) and its associated toxicities. This retrospective study analyzes results of frameless image-guided linear accelerator (LINAC)-based SRS and stereotactic hypofractionated radiotherapy (SHRT) as adjuvant treatment without WBRT. MATERIALS AND METHODS: Between March 2009 and February 2012, 44 resection cavities in 42 patients were treated with SRS (23 cavities) or SHRT (21 cavities). All treatments were delivered using a stereotactic LINAC. All cavities were expanded by ≥ 2 mm in all directions to create the clinical target volume (CTV). RESULTS: The median planning target volume (PTV) for SRS was 11.1 cm(3). The median dose prescribed to the PTV margin for SRS was 17 Gy. Median PTV for SHRT was 22.3 cm(3). The fractionation schemes applied were: 4 fractions of 6 Gy (5 patients), 6 fractions of 4 Gy (6 patients) and 10 fractions of 4 Gy (10 patients). Median follow-up was 9.6 months. Local control (LC) rates after 6 and 12 months were 91 and 77 %, respectively. No statistically significant differences in LC rates between SRS and SHRT treatments were observed. Distant brain control (DBC) rates at 6 and 12 months were 61 and 33 %, respectively. Overall survival (OS) at 6 and 12 months was 87 and 63.5 %, respectively, with a median OS of 15.9 months. One patient treated by SRS showed symptoms of radionecrosis, which was confirmed histologically. CONCLUSION: Frameless image-guided LINAC-based adjuvant SRS and SHRT are effective and well tolerated local treatment strategies after resection of brain metastases in patients with oligometastatic disease.
BACKGROUND: Tumor bed stereotactic radiosurgery (SRS) after resection of brain metastases is a new strategy to delay or avoid whole-brain irradiation (WBRT) and its associated toxicities. This retrospective study analyzes results of frameless image-guided linear accelerator (LINAC)-based SRS and stereotactic hypofractionated radiotherapy (SHRT) as adjuvant treatment without WBRT. MATERIALS AND METHODS: Between March 2009 and February 2012, 44 resection cavities in 42 patients were treated with SRS (23 cavities) or SHRT (21 cavities). All treatments were delivered using a stereotactic LINAC. All cavities were expanded by ≥ 2 mm in all directions to create the clinical target volume (CTV). RESULTS: The median planning target volume (PTV) for SRS was 11.1 cm(3). The median dose prescribed to the PTV margin for SRS was 17 Gy. Median PTV for SHRT was 22.3 cm(3). The fractionation schemes applied were: 4 fractions of 6 Gy (5 patients), 6 fractions of 4 Gy (6 patients) and 10 fractions of 4 Gy (10 patients). Median follow-up was 9.6 months. Local control (LC) rates after 6 and 12 months were 91 and 77 %, respectively. No statistically significant differences in LC rates between SRS and SHRT treatments were observed. Distant brain control (DBC) rates at 6 and 12 months were 61 and 33 %, respectively. Overall survival (OS) at 6 and 12 months was 87 and 63.5 %, respectively, with a median OS of 15.9 months. One patient treated by SRS showed symptoms of radionecrosis, which was confirmed histologically. CONCLUSION: Frameless image-guided LINAC-based adjuvant SRS and SHRT are effective and well tolerated local treatment strategies after resection of brain metastases in patients with oligometastatic disease.
Authors: Paul W Sperduto; Brian Berkey; Laurie E Gaspar; Minesh Mehta; Walter Curran Journal: Int J Radiat Oncol Biol Phys Date: 2007-10-10 Impact factor: 7.038
Authors: Brigitta G Baumert; Isabelle Rutten; Cary Dehing-Oberije; Albert Twijnstra; Miranda J M Dirx; Ria M T L Debougnoux-Huppertz; Philippe Lambin; Bela Kubat Journal: Int J Radiat Oncol Biol Phys Date: 2006-07-11 Impact factor: 7.038
Authors: Paul J Kelly; Yijie Brittany Lin; Alvin Y Yu; Brian M Alexander; Fred Hacker; Karen J Marcus; Stephanie E Weiss Journal: Int J Radiat Oncol Biol Phys Date: 2010-12-17 Impact factor: 7.038
Authors: John C Breneman; Ryan Steinmetz; Aaron Smith; Michael Lamba; Ronald E Warnick Journal: Int J Radiat Oncol Biol Phys Date: 2009-02-21 Impact factor: 7.038
Authors: Brian J Blonigen; Ryan D Steinmetz; Linda Levin; Michael A Lamba; Ronald E Warnick; John C Breneman Journal: Int J Radiat Oncol Biol Phys Date: 2009-09-23 Impact factor: 7.038
Authors: David Mathieu; Douglas Kondziolka; John C Flickinger; David Fortin; Brendan Kenny; Karine Michaud; Sanjay Mongia; Ajay Niranjan; L Dade Lunsford Journal: Neurosurgery Date: 2008-04 Impact factor: 4.654
Authors: Bree R Eaton; Michael J LaRiviere; Michael J La Riviere; Sungjin Kim; Roshan S Prabhu; Kirtesh Patel; Shravan Kandula; Nelson Oyesiku; Jeffrey Olson; Walter Curran; Hui-Kuo Shu; Ian Crocker Journal: J Neurooncol Date: 2015-04-11 Impact factor: 4.130
Authors: Rami A El Shafie; Thorsten Dresel; Dorothea Weber; Daniela Schmitt; Kristin Lang; Laila König; Simon Höne; Tobias Forster; Bastian von Nettelbladt; Tanja Eichkorn; Sebastian Adeberg; Jürgen Debus; Stefan Rieken; Denise Bernhardt Journal: Front Oncol Date: 2020-05-08 Impact factor: 6.244
Authors: Michael T Milano; Jimm Grimm; Andrzej Niemierko; Scott G Soltys; Vitali Moiseenko; Kristin J Redmond; Ellen Yorke; Arjun Sahgal; Jinyu Xue; Anand Mahadevan; Alexander Muacevic; Lawrence B Marks; Lawrence R Kleinberg Journal: Int J Radiat Oncol Biol Phys Date: 2020-09-11 Impact factor: 8.013
Authors: Jennifer Vogel; Eric Ojerholm; Andrew Hollander; Cynthia Briola; Rob Mooij; Michael Bieda; James Kolker; Suneel Nagda; Geoffrey Geiger; Jay Dorsey; Robert Lustig; Donald M O'Rourke; Steven Brem; John Lee; Michelle Alonso-Basanta Journal: Radiat Oncol Date: 2015-10-31 Impact factor: 3.481
Authors: Angelika Bilger; Eva Bretzinger; Jamina Fennell; Carsten Nieder; Hannah Lorenz; Oliver Oehlke; Anca-Ligia Grosu; Hanno M Specht; Stephanie E Combs Journal: Cancer Med Date: 2018-05-09 Impact factor: 4.452