Fulltext

Adjuvant therapy after resection of brain metastases : Frameless image-guided LINAC-based radiosurgery and stereotactic hypofractionated radiotherapy = Adjuvante Therapie nach Resektion von Hirnmetastasen : Rahmenlose bildgesteuerte LINAC-basierte Radiochirurgie und stereotaktische hypofraktionierte Strahlentherapie

Broemme, J. ; Abu-Isa, J. ; Kottke, R. ; Beck, J. ; Wiest, R. ; Malthaner, M. ; Schmidhalter, D. ; Raabe, A. ; Aebersold, D.M. ; Pica, A.

In: Strahlentherapie und Onkologie, 2013, vol. 189, no. 9, p. 765-770

Zum persönliche Liste hinzufügen
    Titel
    • Adjuvant therapy after resection of brain metastases
      Frameless image-guided LINAC-based radiosurgery and stereotactic hypofractionated radiotherapy
    Titel Übersetzung ()
    • Adjuvante Therapie nach Resektion von Hirnmetastasen
    Autor
    • Broemme, J.. Departments of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
    • Abu-Isa, J.. Neurosurgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
    • Kottke, R.. Neuroradiology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
    • Beck, J.. Neurosurgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
    • Wiest, R.. Neuroradiology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
    • Malthaner, M.. Division of Medical Radiation Physics, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
    • Schmidhalter, D.. Division of Medical Radiation Physics, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
    • Raabe, A.. Neurosurgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
    • Aebersold, D.M.. Departments of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
    • Pica, A.. Departments of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • Strahlentherapie und Onkologie, 2013, vol. 189, no. 9, p. 765-770. Springer Berlin Heidelberg
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:315262
    Summary
    Background: Tumor bed stereotactic radiosurgery (SRS) after resection of brain metastases is a new strategy to delay or avoid whole-brain irradiation (WBRT) and its associated toxicities. This retrospective study analyzes results of frameless image-guided linear accelerator (LINAC)-based SRS and stereotactic hypofractionated radiotherapy (SHRT) as adjuvant treatment without WBRT. Materials and methods: Between March 2009 and February 2012, 44resection cavities in 42patients were treated with SRS (23cavities) or SHRT (21cavities). All treatments were delivered using a stereotactic LINAC. All cavities were expanded by ≥ 2mm in all directions to create the clinical target volume (CTV). Results: The median planning target volume (PTV) for SRS was 11.1cm3. The median dose prescribed to the PTV margin for SRS was 17Gy. Median PTV for SHRT was 22.3cm3. The fractionation schemes applied were: 4fractions of 6Gy (5patients), 6fractions of 4Gy (6patients) and 10fractions of 4Gy (10patients). Median follow-up was 9.6months. Local control (LC) rates after 6and 12months were 91and 77 %, respectively. No statistically significant differences in LC rates between SRS and SHRT treatments were observed. Distant brain control (DBC) rates at 6and 12months were 61and 33 %, respectively. Overall survival (OS) at 6and 12months was 87and 63.5 %, respectively, with a median OS of 15.9months. One patient treated by SRS showed symptoms of radionecrosis, which was confirmed histologically. Conclusion: Frameless image-guided LINAC-based adjuvant SRS and SHRT are effective and well tolerated local treatment strategies after resection of brain metastases in patients with oligometastatic disease