Impact of adjuvant fractionated stereotactic radiotherapy dose on local control of brain metastases
| Autor: | Andrew M. Baschnagel, Jacob S. Witt, David M. Francis, Aleksandra Kuczmarska-Haas, Zacariah E. Labby, Poonam Yadav, Michael F. Bassetti, Steven P. Howard, Hima Bindu Musunuru |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Neurology medicine.medical_treatment Kaplan-Meier Estimate Radiosurgery Effective dose (radiation) Metastasis 03 medical and health sciences 0302 clinical medicine medicine Humans Survival analysis Aged Retrospective Studies Aged 80 and over Univariate analysis business.industry Brain Neoplasms Chemoradiotherapy Adjuvant Middle Aged medicine.disease Regimen Treatment Outcome Oncology 030220 oncology & carcinogenesis Female Neurology (clinical) Radiology Dose Fractionation Radiation business Adjuvant 030217 neurology & neurosurgery Brain metastasis |
| Zdroj: | Journal of neuro-oncology. 145(2) |
| ISSN: | 1573-7373 |
| Popis: | The aim of this study was to determine whether a higher biological effective dose (BED) would result in improved local control in patients treated with fractionated stereotactic radiotherapy (FSRT) for their resected brain metastases. Patients with newly diagnosed brain metastases without previous brain radiotherapy were retrospectively reviewed. Patients underwent surgical resection of at least one brain metastasis and were treated with adjuvant FSRT, delivering 25–36 Gy in 5–6 fractions. Outcomes were computed using Kaplan–Meier survival analysis and univariate analysis. Fifty-four patients with 63 post-operative cavities were included. Median follow-up was 16 months (3–60). Median metastasis size at diagnosis was 2.9 cm (0.6–8.1) and median planning target volume was 19.7 cm3 (6.3–68.1). Two-year local control (LC) was 83%. When stratified by dose, 2 years LC rate was 95.1% in those treated with 30–36 Gy in 5–6 fractions (BED10 of 48–57.6 Gy10) versus 59.1% lesions treated with 25 Gy in 5 fractions (BED10 of 37.5 Gy10) (p 37.5 Gy10) were associated with a significantly higher rate of LC compared to lower BED regimens. Overall, 25 Gy in 5 fractions is not an adequate dose to control microscopic disease. If selecting a 5-fraction regimen, 30 Gy in five fractions appears to provide excellent tumor bed control. |
| Databáze: | OpenAIRE |
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