BACKGROUND: This retrospective analysis was performed in order to evaluate the pattern of relapse and the risk of late toxicity for solitary brain metastases treated with surgery and whole-brain radiotherapy and to correlate the results with those from radiosurgical trials. PATIENTS AND METHODS: From a total of 66 patients, 52 received 10 x 3 Gy and 10 were treated with 20 x 2 Gy whole-brain radiotherapy after resection of their brain metastases. RESULTS: The actuarial probability of relapse was 27% and 55% after 1 and 2 year(s), respectively. The local relapse rate (at the original site of resected brain metastases) was rather high for melanoma, non-breast adenocarcinoma, and squamous-cell carcinoma. No local relapse occurred in breast cancer and small-cell carcinoma. Failure elsewhere in the brain seemed to be influenced by extracranial disease activity. Size of brain metastases and total dose showed no correlation with relapse rate. Occurrence of brain relapse was not associated with a reduced survival time, because 10/15 patients who developed a relapse received salvage therapy. Of the patients, 11 had symptoms of late radiation toxicity (the actuarial probability was 42% after 2 years). CONCLUSIONS: Most results of surgical and radiosurgical studies are comparable to ours. Several randomized trials investigate surgical resection versus radiosurgery, as well as the effects of additional whole-brain radiotherapy in order to define the treatment of choice. Some data support the adjuvant application of 10 x 3 Gy over 2 weeks as a reasonable compromise when local control, toxicity, and treatment time have to be considered.
BACKGROUND: This retrospective analysis was performed in order to evaluate the pattern of relapse and the risk of late toxicity for solitary brain metastases treated with surgery and whole-brain radiotherapy and to correlate the results with those from radiosurgical trials. PATIENTS AND METHODS: From a total of 66 patients, 52 received 10 x 3 Gy and 10 were treated with 20 x 2 Gy whole-brain radiotherapy after resection of their brain metastases. RESULTS: The actuarial probability of relapse was 27% and 55% after 1 and 2 year(s), respectively. The local relapse rate (at the original site of resected brain metastases) was rather high for melanoma, non-breast adenocarcinoma, and squamous-cell carcinoma. No local relapse occurred in breast cancer and small-cell carcinoma. Failure elsewhere in the brain seemed to be influenced by extracranial disease activity. Size of brain metastases and total dose showed no correlation with relapse rate. Occurrence of brain relapse was not associated with a reduced survival time, because 10/15 patients who developed a relapse received salvage therapy. Of the patients, 11 had symptoms of late radiation toxicity (the actuarial probability was 42% after 2 years). CONCLUSIONS: Most results of surgical and radiosurgical studies are comparable to ours. Several randomized trials investigate surgical resection versus radiosurgery, as well as the effects of additional whole-brain radiotherapy in order to define the treatment of choice. Some data support the adjuvant application of 10 x 3 Gy over 2 weeks as a reasonable compromise when local control, toxicity, and treatment time have to be considered.
Authors: W T Sause; J J Crowley; R Morantz; M Rotman; P A Mowry; A Bouzaglou; J R Borst; H Selin Journal: Am J Clin Oncol Date: 1990-10 Impact factor: 2.339
Authors: C Y Shiau; P K Sneed; H K Shu; K R Lamborn; M W McDermott; S Chang; P Nowak; P L Petti; V Smith; L J Verhey; M Ho; E Park; W M Wara; P H Gutin; D A Larson Journal: Int J Radiat Oncol Biol Phys Date: 1997-01-15 Impact factor: 7.038
Authors: H Shirato; A Takamura; M Tomita; K Suzuki; T Nishioka; T Isu; T Kato; Y Sawamura; K Miyamachi; H Abe; K Miyasaka Journal: Int J Radiat Oncol Biol Phys Date: 1997-01-15 Impact factor: 7.038
Authors: R M Auchter; J P Lamond; E Alexander; J M Buatti; R Chappell; W A Friedman; T J Kinsella; A B Levin; W R Noyes; C J Schultz; J S Loeffler; M P Mehta Journal: Int J Radiat Oncol Biol Phys Date: 1996-04-01 Impact factor: 7.038
Authors: J C Flickinger; D Kondziolka; L D Lunsford; R J Coffey; M L Goodman; E G Shaw; W R Hudgins; R Weiner; G R Harsh; P K Sneed Journal: Int J Radiat Oncol Biol Phys Date: 1994-03-01 Impact factor: 7.038
Authors: Cameron Brennan; T Jonathan Yang; Patrick Hilden; Zhigang Zhang; Kelvin Chan; Yoshiya Yamada; Timothy A Chan; Stella C Lymberis; Ashwatha Narayana; Viviane Tabar; Philip H Gutin; Åse Ballangrud; Eric Lis; Kathryn Beal Journal: Int J Radiat Oncol Biol Phys Date: 2014-01-01 Impact factor: 7.038
Authors: A Gabriella Wernicke; Menachem Z Yondorf; Bhupesh Parashar; Dattatreyudu Nori; K S Clifford Chao; John A Boockvar; Susan Pannullo; Philip Stieg; Theodore H Schwartz Journal: J Neurooncol Date: 2016-01-02 Impact factor: 4.130
Authors: A Gabriella Wernicke; Menachem Z Yondorf; Luke Peng; Samuel Trichter; Lucy Nedialkova; Albert Sabbas; Fridon Kulidzhanov; Bhupesh Parashar; Dattatreyudu Nori; K S Clifford Chao; Paul Christos; Ilhami Kovanlikaya; Susan Pannullo; John A Boockvar; Philip E Stieg; Theodore H Schwartz Journal: J Neurosurg Date: 2014-05-02 Impact factor: 5.115
Authors: A Gabriella Wernicke; Stefanie P Lazow; Shoshana Taube; Menachem Z Yondorf; Ilhami Kovanlikaya; Dattatreyudu Nori; Paul Christos; John A Boockvar; Susan Pannullo; Philip E Stieg; Theodore H Schwartz Journal: Oper Neurosurg (Hagerstown) Date: 2015-08-01 Impact factor: 2.703
Authors: A S Berghoff; A Ilhan-Mutlu; A Wöhrer; M Hackl; G Widhalm; J A Hainfellner; K Dieckmann; T Melchardt; B Dome; H Heinzl; P Birner; M Preusser Journal: Strahlenther Onkol Date: 2014-02-28 Impact factor: 3.621
Authors: Jadwiga Nowak-Sadzikowska; Tomasz Walasek; Jerzy Jakubowicz; Paweł Blecharz; Marian Reinfuss Journal: Rep Pract Oncol Radiother Date: 2015-12-29
Authors: Eileen P Connolly; Maya Mathew; Moses Tam; Josephine Vera King; Saroj D Kunnakkat; Erik C Parker; John G Golfinos; Michael L Gruber; Ashwatha Narayana Journal: Neuro Oncol Date: 2013-03-03 Impact factor: 12.300