Ken Harada1,2, Hiroshi Igaki3, Eisuke Abe4, Takuro Ariga5, Nobuyuki Hayashi6, Ayae Kanemoto7, Takafumi Komiyama8, Yasuo Matsumoto7, Toshimichi Nakano4, Rikiya Onimaru9, Hirotake Saito4, Minako Sumi10, Masao Tago11, Kensuke Tanaka4, Katsuya Maebayashi12, Hidefumi Aoyama4. 1. Department of Radiation Oncology, School of Medicine, Tokai University, Kanagawa, Japan. 2. Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. 3. Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. hirigaki@ncc.go.jp. 4. Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. 5. Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nakagami, Japan. 6. Department of Radiotherapy, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan. 7. Department of Radiation Oncology, Niigata Cancer Center Hospital, Niigata, Japan. 8. Department of Radiology, University of Yamanashi, Yamanashi, Japan. 9. Department of Radiation Medicine, Graduate School of Medicine, Hokkaido University, Sapporo, Japan. 10. Department of Radiation Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan. 11. Department of Radiology, Teikyo University Mizonokuchi Hospital, Kawasaki, Japan. 12. Division of Radiation Therapy, Nippon Medical School Hospital, Tokyo, Japan.
Abstract
BACKGROUND: To determine the current practice of stereotactic irradiation (STI) for brain metastases in Japan by a questionnaire survey. METHODS: A questionnaire was distributed to 313 institutions performing STI with one of the following machines: Gamma Knife (GK), CyberKnife (CK), Novalis (Nov), or other linear accelerator (LINAC)-based systems (OLS). The participation was voluntary. RESULTS: There were 163 responding institutions. The total number of STI treatments between April 2013 and March 2014 was 10,684. Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (SRT) were performed in 8624 (80.7%) and 2060 (19.3%) cases, respectively. Whole-brain radiation therapy (WBRT) was performed for a total of 3515 cases. For a case model of a 1.5-cm solitary brain metastasis in a non-eloquent area, the most common GTV-PTV margin was 2 mm (22 of 114 institutions), and an institutional standard fraction was 1 (75 of 114 institutions). The doses for the model case also varied from 13.0 to 26.0 Gy (Median 20 Gy) when converted to SRS (α/β = 10). A prescription point was at the PTV margin the most. The median dose constraints which were converted to SRS (α/β = 3) to organs at risk were 12.2, 12.7, and 13.7 Gy for optic nerves, cavernous sinus, and brainstem, respectively. CONCLUSIONS: STI for brain metastases in current practice varied significantly among institutions. These different strategies relied mostly on the type of treatment machine used. It is thus necessary to establish a common guideline to express dose prescriptions and plan qualities for different STI machines.
BACKGROUND: To determine the current practice of stereotactic irradiation (STI) for brain metastases in Japan by a questionnaire survey. METHODS: A questionnaire was distributed to 313 institutions performing STI with one of the following machines: Gamma Knife (GK), CyberKnife (CK), Novalis (Nov), or other linear accelerator (LINAC)-based systems (OLS). The participation was voluntary. RESULTS: There were 163 responding institutions. The total number of STI treatments between April 2013 and March 2014 was 10,684. Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (SRT) were performed in 8624 (80.7%) and 2060 (19.3%) cases, respectively. Whole-brain radiation therapy (WBRT) was performed for a total of 3515 cases. For a case model of a 1.5-cm solitary brain metastasis in a non-eloquent area, the most common GTV-PTV margin was 2 mm (22 of 114 institutions), and an institutional standard fraction was 1 (75 of 114 institutions). The doses for the model case also varied from 13.0 to 26.0 Gy (Median 20 Gy) when converted to SRS (α/β = 10). A prescription point was at the PTV margin the most. The median dose constraints which were converted to SRS (α/β = 3) to organs at risk were 12.2, 12.7, and 13.7 Gy for optic nerves, cavernous sinus, and brainstem, respectively. CONCLUSIONS: STI for brain metastases in current practice varied significantly among institutions. These different strategies relied mostly on the type of treatment machine used. It is thus necessary to establish a common guideline to express dose prescriptions and plan qualities for different STI machines.
Entities:
Keywords:
Brain metastases; Stereotactic irradiation; Survey in Japan
Authors: Jill S Barnholtz-Sloan; Andrew E Sloan; Faith G Davis; Fawn D Vigneau; Ping Lai; Raymond E Sawaya Journal: J Clin Oncol Date: 2004-07-15 Impact factor: 44.544
Authors: R A Patchell; P A Tibbs; W F Regine; R J Dempsey; M Mohiuddin; R J Kryscio; W R Markesbery; K A Foon; B Young Journal: JAMA Date: 1998-11-04 Impact factor: 56.272