Prospective assessment of mask versus frame fixation during Gamma Knife treatment for brain metastases
| Autor: | Mario Grimm, Sabine K. Mai, Arne Mathias Ruder, Martin Polednik, Florian Stieler, Frank A. Giordano, Grit Welzel, Frederik Wenz, Ulrich Köppen |
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| Rok vydání: | 2020 |
| Předmět: |
Frame based
medicine.medical_treatment Gamma knife Radiosurgery 030218 nuclear medicine & medical imaging Stereotactic radiotherapy 03 medical and health sciences 0302 clinical medicine medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Retrospective Studies Fixation (histology) Brain Neoplasms business.industry Local failure Hematology Progression-Free Survival Treatment Outcome Oncology 030220 oncology & carcinogenesis Cohort Nuclear medicine business Leksell gamma knife Follow-Up Studies |
| Zdroj: | Radiotherapy and Oncology. 147:195-199 |
| ISSN: | 0167-8140 |
| Popis: | Purpose The newest generation of the Leksell Gamma Knife (GK) allows frame based as well as frameless treatment. We here report outcomes of a prospective non-randomized study on mask fixation (MF) versus frame fixation (FF) for GK treatment of brain metastases. Methods The decision for FF or MF was made on a case-by-case basis. Factors considered were patients’ preference, proximity of critical structures, V12 and treatment time. Either stereotactic radiosurgery or fractionated stereotactic radiotherapy in up to 3 fractions was performed. For MF, a PTV margin of 1 mm was added. Follow-up included quarterly MRI scans. The primary outcome was local control. Secondary endpoints were progression-free survival (PFS), overall survival (OS) and the incidence of radionecrosis. Results A total of 197 lesions (169 FF and 28 MF) were treated in 76 patients (59 FF and 17 MF). 187 lesions were treated with SRS and 10 with FSRT. Median dose was 22 Gy in both groups and median follow-up was 9.3 months. There was a higher local failure rate (HR: 3.69; 95%CI: 1.13–12.0; p = 0.03) with 11 local failures in the FF and none in the MF cohort. No differences were observed between the groups for OS (median: n.r. vs. 16.9 months; HR:1.00; 95%CI: 0.41–2.46; p = 0.999) and PFS (median: 6.9 vs. 8.4 months; HR: 0.92; 95%CI: 0.47–1.79; p = 0.800). Three cases of radionecrosis occurred with FF but none with MF (p = 0.67). Conclusions Gamma Knife treatment with MF does not result in worse outcome or increased rates of radionecrosis in this non-randomized study. |
| Databáze: | OpenAIRE |
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