Hypofractionated postoperative stereotactic radiotherapy for large resected brain metastases
Copyright © 2022 Société française de radiothérapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved..
PURPOSE: The aim of the present retrospective study was to report outcomes after hypofractionated stereotactic radiotherapy (HSRT) for resected brain metastases (BM).
PATIENTS AND METHODS: We reviewed results of patients with resected BM treated with postoperative HSRT (3×7.7Gy to the prescription isodose 70%) between May 2013 and June 2020. Local control (LC), distant brain control (DBC), overall survival (OS), leptomeningeal disease relapse (LMDR), and radiation necrosis (RN) occurrence were reported.
RESULTS: Twenty-two patients with 23 brain cavities were included. Karnofsky Performance status (KPS) was≥70 in 77.3%. Median preoperative diameter was 37mm [21.0-75.0] and median planning target volume (PTV) was 23 cm3 [9.9-61.6]. Median time from surgery to SRT was 69 days [7-101] and 48% of patients had a local relapse on pre-SRT imaging. Median follow-up was 17.5 months [1.6-95.9]. One and two-year LC rates were 60.9 and 52.2% respectively. One and 2-year DBC rates were 45.5 and 40.9%. Median OS was 16.5 months. Four patients (18.2%) presented LMDR during follow-up. RN occurred in 6 patients (27.2%). Three factors were associated with OS: ECOG-PS (P=0.009), KPS (P=0.04), cystic or solid nature of the metastasis before surgery (P=0.037). Several factors were related to RN occurrence: PTV diameter and volume, Normal brain V21, V21 and V24 isodoses volumes.
CONCLUSION: HSRT is the most widely used scheme for larger brain cavities after surgery. The optimal dose and scheme remain to be defined as well as the optimal delay between postoperative SRT and surgery. Dose escalation may be necessary, especially in case of subtotal resection.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
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| Enthalten in: |
Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique - 27(2023), 2 vom: 05. Apr., Seite 87-95 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Evin, C [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 05.04.2023 Date Revised 05.04.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.canrad.2022.07.006 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM345929136 |
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| 100 | 1 | |a Evin, C |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Hypofractionated postoperative stereotactic radiotherapy for large resected brain metastases |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 05.04.2023 | ||
| 500 | |a Date Revised 05.04.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Société française de radiothérapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved. | ||
| 520 | |a PURPOSE: The aim of the present retrospective study was to report outcomes after hypofractionated stereotactic radiotherapy (HSRT) for resected brain metastases (BM) | ||
| 520 | |a PATIENTS AND METHODS: We reviewed results of patients with resected BM treated with postoperative HSRT (3×7.7Gy to the prescription isodose 70%) between May 2013 and June 2020. Local control (LC), distant brain control (DBC), overall survival (OS), leptomeningeal disease relapse (LMDR), and radiation necrosis (RN) occurrence were reported | ||
| 520 | |a RESULTS: Twenty-two patients with 23 brain cavities were included. Karnofsky Performance status (KPS) was≥70 in 77.3%. Median preoperative diameter was 37mm [21.0-75.0] and median planning target volume (PTV) was 23 cm3 [9.9-61.6]. Median time from surgery to SRT was 69 days [7-101] and 48% of patients had a local relapse on pre-SRT imaging. Median follow-up was 17.5 months [1.6-95.9]. One and two-year LC rates were 60.9 and 52.2% respectively. One and 2-year DBC rates were 45.5 and 40.9%. Median OS was 16.5 months. Four patients (18.2%) presented LMDR during follow-up. RN occurred in 6 patients (27.2%). Three factors were associated with OS: ECOG-PS (P=0.009), KPS (P=0.04), cystic or solid nature of the metastasis before surgery (P=0.037). Several factors were related to RN occurrence: PTV diameter and volume, Normal brain V21, V21 and V24 isodoses volumes | ||
| 520 | |a CONCLUSION: HSRT is the most widely used scheme for larger brain cavities after surgery. The optimal dose and scheme remain to be defined as well as the optimal delay between postoperative SRT and surgery. Dose escalation may be necessary, especially in case of subtotal resection | ||
| 650 | 4 | |a Review | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Brain cavities | |
| 650 | 4 | |a Brain metastases | |
| 650 | 4 | |a Cavité opératoire | |
| 650 | 4 | |a Grand volume | |
| 650 | 4 | |a Hypofractionated stereotaxtic radiotherapy | |
| 650 | 4 | |a Large resected metastasis | |
| 650 | 4 | |a Métastases cérébrales | |
| 650 | 4 | |a Radiothérapie stéréotaxique | |
| 650 | 4 | |a Radiothérapie stéréotaxique hypofractionnée | |
| 650 | 4 | |a Stereotactic radiotherapy | |
| 700 | 1 | |a Eude, Y |e verfasserin |4 aut | |
| 700 | 1 | |a Jacob, J |e verfasserin |4 aut | |
| 700 | 1 | |a Jenny, C |e verfasserin |4 aut | |
| 700 | 1 | |a Bourdais, R |e verfasserin |4 aut | |
| 700 | 1 | |a Mathon, B |e verfasserin |4 aut | |
| 700 | 1 | |a Valery, C A |e verfasserin |4 aut | |
| 700 | 1 | |a Clausse, E |e verfasserin |4 aut | |
| 700 | 1 | |a Simon, J M |e verfasserin |4 aut | |
| 700 | 1 | |a Maingon, P |e verfasserin |4 aut | |
| 700 | 1 | |a Feuvret, L |e verfasserin |4 aut | |
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