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Five-fraction stereotactic radiotherapy for brain metastases: a retrospective analysis

Purpose: To determine the safety and outcome profile of five-fraction stereotactic radiotherapy (FSRT) for brain metastases (BM), either as a definitive or adjuvant treatment. Methods: We assessed clinical data of patients receiving five fractions of 7 Gy each (cumulative physical dose of 35 Gy) to...

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Main Authors: Layer, Julian (Author) , Layer, Katharina (Author) , Sarria, Gustavo R. (Author) , Röhner, Fred (Author) , Dejonckheere, Cas S. (Author) , Friker, Lea L. (Author) , Zeyen, Thomas (Author) , Koch, David (Author) , Scafa, Davide (Author) , Leitzen, Christina (Author) , Köksal, Mümtaz (Author) , Schmeel, Frederic Carsten (Author) , Schäfer, Niklas (Author) , Landsberg, Jennifer (Author) , Hölzel, Michael (Author) , Herrlinger, Ulrich (Author) , Schneider, Matthias (Author) , Giordano, Frank Anton (Author) , Schmeel, Leonard Christopher (Author)
Format: Article (Journal)
Language:English
Published: 17 January 2023
In: Current oncology
Year: 2023, Volume: 30, Issue: 2, Pages: 1300-1313
ISSN:1718-7729
DOI:10.3390/curroncol30020101
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3390/curroncol30020101
Verlag, kostenfrei, Volltext: https://www.mdpi.com/1718-7729/30/2/101
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Author Notes:Julian P. Layer, Katharina Layer, Gustavo R. Sarria, Fred Röhner, Cas S. Dejonckheere, Lea L. Friker, Thomas Zeyen, David Koch, Davide Scafa, Christina Leitzen, Mümtaz Köksal, Frederic Carsten Schmeel, Niklas Schäfer, Jennifer Landsberg, Michael Hölzel, Ulrich Herrlinger, Matthias Schneider, Frank A. Giordano and Leonard Christopher Schmeel
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Summary:Purpose: To determine the safety and outcome profile of five-fraction stereotactic radiotherapy (FSRT) for brain metastases (BM), either as a definitive or adjuvant treatment. Methods: We assessed clinical data of patients receiving five fractions of 7 Gy each (cumulative physical dose of 35 Gy) to BM or surgical cavities. The primary endpoints were toxicity and radiation necrosis (RN) rates. Secondary endpoints were 1-year cumulative local control rate (LCR) and estimated overall survival (OS). Results: A total of 36 eligible patients receiving FSRT to a total of 49 targets were identified and included. The median follow up was 9 (1.1-56.2) months. The median age was 64.5 (34-92) years, the median ECOG score was 1, and the median Diagnostic-Specific Graded Prognostic Assessment (DS-GPA) score was 2. Treatment was well tolerated and there were no grade 3 adverse events or higher. The overall RN rate was 14.3% and the median time to RN was 12.9 (1.8-23.8) months. RN occurrence was associated with immunotherapy, young age (≤45 years), and large PTV. The cumulative 1-year local control rate was 83.1% and the estimated median local progression free-survival was 18.8 months. The estimated median overall survival was 11 (1.1-56.2) months and significantly superior in those patients presenting with RN. Conclusions: FSRT with 5 × 7 Gy represents a feasible, safe, and efficient fast track approach of intensified FSRT with acceptable LC and comparable RN rates for both the adjuvant and definitive RT settings.
Item Description:Gesehen am 30.09.2024
Physical Description:Online Resource
ISSN:1718-7729
DOI:10.3390/curroncol30020101

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