Population-Based Real-World Outcomes of Post-Operative Adjuvant Brain Cavity Radiotherapy Versus Observation
To evaluate the factors influencing the outcomes of patients who underwent surgical resection of brain metastasis followed by either surveillance or post-operative stereotactic radiosurgery/fractionated radiotherapy (SRS/SFRT), a retrospective multi-center chart review was performed on all patients...
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MDPI AG
2025-06-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/32/6/345 |
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| author | Zhang Hao (Jim) Li Linden Lechner Jennifer Wang Nan Hui (Susan) Yao Andrew Lee Serge Makarenko Mostafa Fatehi Herve H. F. Choi Ermias Gete Fred Hsu Waseem Sharieff Shrinivas Rathod Hannah Carolan Jessica Chan Roy Ma Alan Nichol Thi Nghiem Justin Oh |
| author_facet | Zhang Hao (Jim) Li Linden Lechner Jennifer Wang Nan Hui (Susan) Yao Andrew Lee Serge Makarenko Mostafa Fatehi Herve H. F. Choi Ermias Gete Fred Hsu Waseem Sharieff Shrinivas Rathod Hannah Carolan Jessica Chan Roy Ma Alan Nichol Thi Nghiem Justin Oh |
| author_sort | Zhang Hao (Jim) Li |
| collection | DOAJ |
| description | To evaluate the factors influencing the outcomes of patients who underwent surgical resection of brain metastasis followed by either surveillance or post-operative stereotactic radiosurgery/fractionated radiotherapy (SRS/SFRT), a retrospective multi-center chart review was performed on all patients who underwent brain metastases resection in British Columbia between 2018 and 2020. Patients with prior whole-brain radiotherapy were excluded from the study. The primary study endpoints included local recurrence, distant intracranial control, radionecrosis (RN), leptomeningeal disease (LMD), and overall survival (OS). The Kaplan–Meier method was used to analyze survival. The Cox proportional hazards model was used to perform univariable (UVA) and multivariable (MVA) analyses to identify predictors of local control. A total of 113 patients met the inclusion criteria. A total of 31 patients received adjuvant SRS/SFRT to the surgical cavity, while 82 went on observation. The 12-month local control was 69% (50–88%) for the SRS/SFRT cohort and 31% (18–45%) for the observation cohort (<i>p</i> < 0.001). The 12-month distant intracranial control was 44% (26–63%) for the SRS/SFRT cohort and 46% (30–62%) for the observation cohort (<i>p</i> = 0.9). Sensitivity analysis did not show a difference in overall survival (<i>p</i> = 0.6). En bloc resection (<i>p</i> < 0.05), resection without residual disease (<i>p</i> < 0.05), and SRS/SFRT (<i>p</i> < 0.001) were predictive of local control on MVA. Three SRS/SFRT patients (10%) and two observation patients (2%) developed LMD. Four SRS/SFRT patients experienced RN (13%), with no grade 3 or higher toxicities observed. Post-operative SRT outcomes based on real-world population data are consistent with the data from clinical trials and support the established guidelines. For patients requiring surgical resection of brain metastasis, en bloc gross total resection should be encouraged when feasible to reduce local recurrence. |
| format | Article |
| id | doaj-art-1e9541a1cbfd432aace98a1bfb8020f0 |
| institution | Kabale University |
| issn | 1198-0052 1718-7729 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
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| series | Current Oncology |
| spelling | doaj-art-1e9541a1cbfd432aace98a1bfb8020f02025-08-20T03:27:23ZengMDPI AGCurrent Oncology1198-00521718-77292025-06-0132634510.3390/curroncol32060345Population-Based Real-World Outcomes of Post-Operative Adjuvant Brain Cavity Radiotherapy Versus ObservationZhang Hao (Jim) Li0Linden Lechner1Jennifer Wang2Nan Hui (Susan) Yao3Andrew Lee4Serge Makarenko5Mostafa Fatehi6Herve H. F. Choi7Ermias Gete8Fred Hsu9Waseem Sharieff10Shrinivas Rathod11Hannah Carolan12Jessica Chan13Roy Ma14Alan Nichol15Thi Nghiem16Justin Oh17Division of Radiation Oncology, Department of Surgery, University of British Columbia, Vancouver, BC V5Z 4E6, CanadaFaculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, CanadaFaculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, CanadaFaculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, CanadaDivision of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, BC V5Z 1M9, CanadaDivision of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, BC V5Z 1M9, CanadaDivision of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, BC V5Z 1M9, CanadaDivision of Radiation Oncology, Department of Surgery, University of British Columbia, Vancouver, BC V5Z 4E6, CanadaDivision of Radiation Oncology, Department of Surgery, University of British Columbia, Vancouver, BC V5Z 4E6, CanadaDivision of Radiation Oncology, Department of Surgery, University of British Columbia, Vancouver, BC V5Z 4E6, CanadaDivision of Radiation Oncology, Department of Surgery, University of British Columbia, Vancouver, BC V5Z 4E6, CanadaDivision of Radiation Oncology, Department of Surgery, University of British Columbia, Vancouver, BC V5Z 4E6, CanadaDivision of Radiation Oncology, Department of Surgery, University of British Columbia, Vancouver, BC V5Z 4E6, CanadaDivision of Radiation Oncology, Department of Surgery, University of British Columbia, Vancouver, BC V5Z 4E6, CanadaDivision of Radiation Oncology, Department of Surgery, University of British Columbia, Vancouver, BC V5Z 4E6, CanadaDivision of Radiation Oncology, Department of Surgery, University of British Columbia, Vancouver, BC V5Z 4E6, CanadaData and Analytics, BC Cancer Agency, Vancouver, BC V5Z 4E6, CanadaDivision of Radiation Oncology, Department of Surgery, University of British Columbia, Vancouver, BC V5Z 4E6, CanadaTo evaluate the factors influencing the outcomes of patients who underwent surgical resection of brain metastasis followed by either surveillance or post-operative stereotactic radiosurgery/fractionated radiotherapy (SRS/SFRT), a retrospective multi-center chart review was performed on all patients who underwent brain metastases resection in British Columbia between 2018 and 2020. Patients with prior whole-brain radiotherapy were excluded from the study. The primary study endpoints included local recurrence, distant intracranial control, radionecrosis (RN), leptomeningeal disease (LMD), and overall survival (OS). The Kaplan–Meier method was used to analyze survival. The Cox proportional hazards model was used to perform univariable (UVA) and multivariable (MVA) analyses to identify predictors of local control. A total of 113 patients met the inclusion criteria. A total of 31 patients received adjuvant SRS/SFRT to the surgical cavity, while 82 went on observation. The 12-month local control was 69% (50–88%) for the SRS/SFRT cohort and 31% (18–45%) for the observation cohort (<i>p</i> < 0.001). The 12-month distant intracranial control was 44% (26–63%) for the SRS/SFRT cohort and 46% (30–62%) for the observation cohort (<i>p</i> = 0.9). Sensitivity analysis did not show a difference in overall survival (<i>p</i> = 0.6). En bloc resection (<i>p</i> < 0.05), resection without residual disease (<i>p</i> < 0.05), and SRS/SFRT (<i>p</i> < 0.001) were predictive of local control on MVA. Three SRS/SFRT patients (10%) and two observation patients (2%) developed LMD. Four SRS/SFRT patients experienced RN (13%), with no grade 3 or higher toxicities observed. Post-operative SRT outcomes based on real-world population data are consistent with the data from clinical trials and support the established guidelines. For patients requiring surgical resection of brain metastasis, en bloc gross total resection should be encouraged when feasible to reduce local recurrence.https://www.mdpi.com/1718-7729/32/6/345stereotactic radiotherapystereotactic radiosurgerypalliative radiotherapyCNS metastasisradionecrosisleptomeningeal disease |
| spellingShingle | Zhang Hao (Jim) Li Linden Lechner Jennifer Wang Nan Hui (Susan) Yao Andrew Lee Serge Makarenko Mostafa Fatehi Herve H. F. Choi Ermias Gete Fred Hsu Waseem Sharieff Shrinivas Rathod Hannah Carolan Jessica Chan Roy Ma Alan Nichol Thi Nghiem Justin Oh Population-Based Real-World Outcomes of Post-Operative Adjuvant Brain Cavity Radiotherapy Versus Observation Current Oncology stereotactic radiotherapy stereotactic radiosurgery palliative radiotherapy CNS metastasis radionecrosis leptomeningeal disease |
| title | Population-Based Real-World Outcomes of Post-Operative Adjuvant Brain Cavity Radiotherapy Versus Observation |
| title_full | Population-Based Real-World Outcomes of Post-Operative Adjuvant Brain Cavity Radiotherapy Versus Observation |
| title_fullStr | Population-Based Real-World Outcomes of Post-Operative Adjuvant Brain Cavity Radiotherapy Versus Observation |
| title_full_unstemmed | Population-Based Real-World Outcomes of Post-Operative Adjuvant Brain Cavity Radiotherapy Versus Observation |
| title_short | Population-Based Real-World Outcomes of Post-Operative Adjuvant Brain Cavity Radiotherapy Versus Observation |
| title_sort | population based real world outcomes of post operative adjuvant brain cavity radiotherapy versus observation |
| topic | stereotactic radiotherapy stereotactic radiosurgery palliative radiotherapy CNS metastasis radionecrosis leptomeningeal disease |
| url | https://www.mdpi.com/1718-7729/32/6/345 |
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