| Autor: |
Al-Omair, Ameen, Soliman, Hany, Xu, Wei, Karotki, Aliaksandr, Mainprize, Todd, Phan, Nicolas, Das, Sunit, Keith, Julia, Yeung, Robert, Perry, James, Tsao, May, Sahgal, Arjun |
| Zdroj: |
Technology in Cancer Research & Treatment; December 2013, Vol. 12 Issue: 6 p493-499, 7p |
| Abstrakt: |
Our purpose was to report efficacy of hypofractionated cavity stereotactic radiotherapy (HCSRT) in patients with and without prior whole brain radiotherapy (WBRT). 32 surgical cavities in 30 patients (20 patients/21 cavities had no prior WBRT and 10 patients/11 cavities had prior WBRT) were treated with image-guided linac stereotactic radiotherapy. 7 of the 10 prior WBRT patients had “resistant” local disease given prior surgery, post-operative WBRT and a re-operation, followed by salvage HCSRT. The clinical target volume was the post-surgical cavity, and a 2-mm margin applied as planning target volume. The median total dose was 30 Gy (range: 25–37.5 Gy) in 5 fractions. In the no prior and prior WBRT cohorts, the median follow-up was 9.7 months (range: 3.0–23.6) and 15.3 months (range: 2.9–39.7), the median survival was 23.6 months and 39.7 months, and the 1-year cavity local recurrence progression-free survival (LRFS) was 79 and 100%, respectively. At 18 months the LRFS dropped to 29% in the prior WBRT cohort. Grade 3 radiation necrosis occurred in 3 prior WBRT patients. We report favorable outcomes with HCSRT, and well selected patients with prior WBRT and “resistant” disease may have an extended survival favoring aggressive salvage HCSRT at a moderate risk of radiation necrosis. |
| Databáze: |
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