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Journal of Neuro-Oncology
Erschienen in:

10.01.2022 | Clinical Study

Stereotactic Laser Ablation (SLA) followed by consolidation stereotactic radiosurgery (cSRS) as treatment for brain metastasis that recurred locally after initial radiosurgery (BMRS): a multi-institutional experience

verfasst von: Isabela Peña Pino, Jun Ma, Yusuke S. Hori, Elena Fomchenko, Kathryn Dusenbery, Margaret Reynolds, Christopher Wilke, Jianling Yuan, Ethan Srinivasan, Matthew Grabowski, Peter Fecci, Evidio Domingo-Musibay, Naomi Fujioka, Gene H. Barnett, Veronica Chang, Alireza M. Mohammadi, Clark C. Chen

Erschienen in: Journal of Neuro-Oncology | Ausgabe 2/2022

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Abstract

Introduction

The optimal treatment paradigm for brain metastasis that recurs locally after initial radiosurgery remains an area of active investigation. Here, we report outcomes for patients with BMRS treated with stereotactic laser ablation (SLA, also known as laser interstitial thermal therapy, LITT) followed by consolidation radiosurgery.

Methods

Clinical outcomes of 20 patients with 21 histologically confirmed BMRS treated with SLA followed by consolidation SRS and > 6 months follow-up were collected retrospectively across three participating institutions.

Results

Consolidation SRS (5 Gy × 5 or 6 Gy × 5) was carried out 16–73 days (median of 26 days) post-SLA in patients with BMRS. There were no new neurological deficits after SLA/cSRS. While 3/21 (14.3%) patients suffered temporary Karnofsky Performance Score (KPS) decline after SLA, no KPS decline was observed after cSRS. There were no 30-day mortalities or wound complications. Two patients required re-admission within 30 days of cSRS (severe headache that resolved with steroid therapy (n = 1) and new onset seizure (n = 1)). With a median follow-up of 228 days (range: 178–1367 days), the local control rate at 6 and 12 months (LC6, LC12) was 100%. All showed diminished FLAIR volume surrounding the SLA/cSRS treated BMRS at the six-month follow-up; none of the patients required steroid for symptoms attributable to these BMRS. These results compare favorably to the available literature for repeat SRS or SLA-only treatment of BMRS.

Conclusions

This multi-institutional experience supports further investigations of SLA/cSRS as a treatment strategy for BMRS.
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Metadaten
Titel
Stereotactic Laser Ablation (SLA) followed by consolidation stereotactic radiosurgery (cSRS) as treatment for brain metastasis that recurred locally after initial radiosurgery (BMRS): a multi-institutional experience
verfasst von
Isabela Peña Pino
Jun Ma
Yusuke S. Hori
Elena Fomchenko
Kathryn Dusenbery
Margaret Reynolds
Christopher Wilke
Jianling Yuan
Ethan Srinivasan
Matthew Grabowski
Peter Fecci
Evidio Domingo-Musibay
Naomi Fujioka
Gene H. Barnett
Veronica Chang
Alireza M. Mohammadi
Clark C. Chen
Publikationsdatum
10.01.2022
Verlag
Springer US
Erschienen in
Journal of Neuro-Oncology / Ausgabe 2/2022
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-021-03893-6

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