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21.09.2021 | Clinical Study

Five fraction stereotactic radiotherapy after brain metastasectomy: a single-institution experience and literature review

verfasst von: S. Rogers, A. Stauffer, N. Lomax, S. Alonso, B. Eberle, S. Gomez Ordoñez, T. Lazeroms, E. Kessler, M. Brendel, L. Schwyzer, O. Riesterer

Erschienen in: Journal of Neuro-Oncology | Ausgabe 1/2021

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Abstract

Purpose

The outcomes of five fraction stereotactic radiotherapy (hfSRT) following brain metastasectomy were evaluated and compared with published series.

Methods

30 Gy in 5 fractions HfSRT prescribed to the surgical cavity was reduced to 25 Gy if the volume of ‘brain−GTV’ receiving 20 Gy exceeded 20 cm³. Endpoints were local recurrence, nodular leptomeningeal recurrence, new brain metastases and radionecrosis. The literature was searched for reports of clinical and dosimetric outcomes following postoperative hfSRT in 3–5 fractions.

Results

39 patients with 40 surgical cavities were analyzed. Cavity local control rate at 1 year was 33/40 (82.5%). 3 local failures followed 30 Gy/5 fractions and 4 with 25 Gy/5 fractions. The incidence of leptomeningeal disease (LMD) was 7/40 (17.5%). No grade 3–4 toxicities, particularly no radionecrosis, were reported. The incidence of distant brain metastases was 15/40 (37.5%). The median overall survival was 15 months. Across 13 published series, the weighted mean local control was 83.1% (adjusted for sample size), the mean incidence of LMD was 14.9% (7–34%) and the mean rate of radionecrosis was 10.3% (0–20.6%).

Conclusion

Postoperative hfSRT can be delivered with 25–30 Gy in 5 fractions with efficacy in excess of 82% and no significant toxicity when the dose to ‘brain−GTV’ does not exceed 20 cm³.

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Titel: Five fraction stereotactic radiotherapy after brain metastasectomy: a single-institution experience and literature review
verfasst von: S. Rogers
A. Stauffer
N. Lomax
S. Alonso
B. Eberle
S. Gomez Ordoñez
T. Lazeroms
E. Kessler
M. Brendel
L. Schwyzer
O. Riesterer
Publikationsdatum: 21.09.2021
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 1/2021
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-021-03840-5

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Five fraction stereotactic radiotherapy after brain metastasectomy: a single-institution experience and literature review

Abstract

Purpose

Methods

Results

Conclusion

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Abstract

Purpose

Methods

Results

Conclusion

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