Stereotactic reirradiation for local failure of brain metastases following previous radiosurgery
| Autor: | Lorenzo Livi, Icro Meattini, Silvia Scoccianti, Joost J. Nuyttens, Daniela Greto, Kim C. de Vries, Pierluigi Bonomo, Giulio Francolini, Saverio Caini, Mauro Loi, Isacco Desideri, Gabriele Simontacchi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty medicine.medical_treatment Subgroup analysis Radiosurgery Re-Irradiation 03 medical and health sciences 0302 clinical medicine Patient age Medicine Humans Retrospective Studies business.industry Brain Neoplasms Incidence (epidemiology) Local failure Hematology Confidence interval 030104 developmental biology Treatment Outcome Oncology 030220 oncology & carcinogenesis Meta-analysis Radiology Brain metastases In-field recurrence Radionecrosis Reirradiation Repeat irradiation Second stereotactic radiosurgery Stereotactic radiosurgery Cranial Irradiation Neoplasm Recurrence Local business Previously treated |
| Zdroj: | Critical Reviews in Oncology/Hematology. 153 |
| ISSN: | 1040-8428 |
| Popis: | Introduction Local failure (LF) following stereotactic radiosurgery (SRS) of brain metastases (BM) may be treated with a second course of SRS (SRS2), though this procedure may increase the risk of symptomatic radionecrosis (RN). Methods A literature search was conducted according to PRISMA to identify studies reporting LF, overall survival (OS) and RN rates following SRS2. Meta-analysis was performed to identify predictors of RN. Results Analysis included 11 studies (335 patients,389 metastases). Pooled 1-year LF was 24 %(CI95 % 19–30 %): heterogeneity was acceptable (I2 = 21.4 %). Median pooled OS was 14 months (Confidence Interval 95 %, CI95 % 8.8–22.0 months). Cumulative crude RN rate was 13 % (95 %CI 8 %–19 %), with acceptable heterogeneity (I2 = 40.3 %). Subgroup analysis showed higher RN incidence in studies with median patient age ≥59 years (13 % [95 %CI 8 %–19 %] vs 7 %[95 %CI 3 %–12 %], p = 0.004) and lower incidence following prior Whole Brain Radiotherapy (WBRT, 19 %[95 %CI 13 %–25 %] vs 7%[95 %CI 3 %–13 %], p = 0.004). Conclusions SRS2 is an effective strategy for in-site recurrence of BM previously treated with SRS. |
| Databáze: | OpenAIRE |
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