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Journal of Cancer Research and Clinical Oncology

Erschienen in:

01.09.2012 | Original Paper

Hypofractionated stereotactic radiotherapy (hfSRT) after tumour resection of a single brain metastasis: report of a single-centre individualized treatment approach

verfasst von: Diana Steinmann, Bettina Maertens, Stefan Janssen, Martin Werner, Jörg Frühauf, Makoto Nakamura, Hans Christiansen, Michael Bremer

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 9/2012

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Abstract

Purpose

Standard treatment of single brain metastases so far is tumour resection in combination with postoperative whole-brain radiotherapy or stereotactic radiosurgery. Here, we report retrospectively our first experience with postoperative hypofractionated stereotactic radiotherapy (hfSRT) to the resection cavity in order to replace upfront WBRT with respect to treatment efficacy and safety.

Methods

Between March 2006 and October 2011, 33 patients with a single newly diagnosed intracranial metastasis were treated with hfSRT following microsurgical resection. Fractionation concepts were 10 × 4 Gy (n = 22), 7 × 5 Gy (n = 7) and 5 × 6 Gy (n = 4). Planning target volume enclosed the tumour resection cavity with a safety margin of 4 mm.

Results

No patient demonstrated toxicity grade 2 or higher. Actuarial median overall survival summed up to 20.2 months, and 12-month survival was 64 %. Actuarial mean local brain control was 30.6 months, median distant brain control 12.4 months and intracranial control 8.8 months, respectively. Actuarial 1-year rates of local, distant brain and intracranial control were 71, 57 and 43 %. Salvage whole-brain radiotherapy due to recurrent brain metastases was performed in 13 patients (39 %).

Conclusion

Postoperative hfSRT appears to be a feasible treatment option in patients with a single newly diagnosed brain metastasis. Replacing the standard postoperative whole-brain radiotherapy necessitates compliant patients and regular MRI follow-up analysis.

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Titel: Hypofractionated stereotactic radiotherapy (hfSRT) after tumour resection of a single brain metastasis: report of a single-centre individualized treatment approach
verfasst von: Diana Steinmann
Bettina Maertens
Stefan Janssen
Martin Werner
Jörg Frühauf
Makoto Nakamura
Hans Christiansen
Michael Bremer
Publikationsdatum: 01.09.2012
Verlag: Springer-Verlag
Erschienen in: Journal of Cancer Research and Clinical Oncology / Ausgabe 9/2012
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-012-1227-x

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Hypofractionated stereotactic radiotherapy (hfSRT) after tumour resection of a single brain metastasis: report of a single-centre individualized treatment approach