Multicenter analysis of stereotactic radiotherapy of the resection cavity in patients with brain metastases
Abstract Brain metastases show a recurrence rate of about 50% after surgical resection. Adjuvant radiotherapy can prevent progression; however, whole‐brain radiotherapy (WBRT) can be associated with significant side effects. Local hypofractionated stereotactic radiotherapy (HFSRT) is a good alternat...
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| Format: | Article |
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Wiley
2018-06-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.1477 |
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| author | Stephanie E. Combs Angelika Bilger Christian Diehl Eva Bretzinger Hannah Lorenz Oliver Oehlke Hanno M. Specht Anna Kirstein Anca‐Ligia Grosu |
| author_facet | Stephanie E. Combs Angelika Bilger Christian Diehl Eva Bretzinger Hannah Lorenz Oliver Oehlke Hanno M. Specht Anna Kirstein Anca‐Ligia Grosu |
| author_sort | Stephanie E. Combs |
| collection | DOAJ |
| description | Abstract Brain metastases show a recurrence rate of about 50% after surgical resection. Adjuvant radiotherapy can prevent progression; however, whole‐brain radiotherapy (WBRT) can be associated with significant side effects. Local hypofractionated stereotactic radiotherapy (HFSRT) is a good alternative to provide local control with minimal toxicity. In this multicenter analysis, we evaluated the treatment outcome of local HFSRT after resection brain metastases in 181 patients. Patient's characteristics, treatment data as well as follow‐up data were collected and analyzed with special focus on local control, locoregional control and survival. After a median follow‐up of 12.6 months (range 0.3–80.2 months), the crude rate for local control was 80.5%; 1‐ and 2‐year local recurrence‐free survival rates were 75% and 70% (median not reached). Resection cavity size was a significant predictor for local recurrence (P = 0.033). The median overall survival was 16.0 months. Both graded prognostic assessment score and recursive partitioning analysis were accurate predictors of survival. HFSRT leads to excellent local control and has a high potential to consolidate results after surgery; acute and late toxicity is low. Distant intracerebral metastases occur frequently during follow‐up, and therefore, a close patient monitoring needs to be warranted if whole‐brain radiotherapy is omitted. |
| format | Article |
| id | doaj-art-3059bf5dac2a4fb3982cfb094cb63c8c |
| institution | DOAJ |
| issn | 2045-7634 |
| language | English |
| publishDate | 2018-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-3059bf5dac2a4fb3982cfb094cb63c8c2025-08-20T03:15:03ZengWileyCancer Medicine2045-76342018-06-01762319232710.1002/cam4.1477Multicenter analysis of stereotactic radiotherapy of the resection cavity in patients with brain metastasesStephanie E. Combs0Angelika Bilger1Christian Diehl2Eva Bretzinger3Hannah Lorenz4Oliver Oehlke5Hanno M. Specht6Anna Kirstein7Anca‐Ligia Grosu8Department of Radiation Oncology Technische Universität München Klinikum rechts der Isar München GermanyDepartment of Radiation Oncology Universitätsklinikum Freiburg Freiburg GermanyDepartment of Radiation Oncology Technische Universität München Klinikum rechts der Isar München GermanyDepartment of Radiation Oncology Universitätsklinikum Freiburg Freiburg GermanyDepartment of Radiation Oncology Universitätsklinikum Freiburg Freiburg GermanyDepartment of Radiation Oncology Universitätsklinikum Freiburg Freiburg GermanyDepartment of Radiation Oncology Technische Universität München Klinikum rechts der Isar München GermanyDepartment of Radiation Oncology Technische Universität München Klinikum rechts der Isar München GermanyDepartment of Radiation Oncology Universitätsklinikum Freiburg Freiburg GermanyAbstract Brain metastases show a recurrence rate of about 50% after surgical resection. Adjuvant radiotherapy can prevent progression; however, whole‐brain radiotherapy (WBRT) can be associated with significant side effects. Local hypofractionated stereotactic radiotherapy (HFSRT) is a good alternative to provide local control with minimal toxicity. In this multicenter analysis, we evaluated the treatment outcome of local HFSRT after resection brain metastases in 181 patients. Patient's characteristics, treatment data as well as follow‐up data were collected and analyzed with special focus on local control, locoregional control and survival. After a median follow‐up of 12.6 months (range 0.3–80.2 months), the crude rate for local control was 80.5%; 1‐ and 2‐year local recurrence‐free survival rates were 75% and 70% (median not reached). Resection cavity size was a significant predictor for local recurrence (P = 0.033). The median overall survival was 16.0 months. Both graded prognostic assessment score and recursive partitioning analysis were accurate predictors of survival. HFSRT leads to excellent local control and has a high potential to consolidate results after surgery; acute and late toxicity is low. Distant intracerebral metastases occur frequently during follow‐up, and therefore, a close patient monitoring needs to be warranted if whole‐brain radiotherapy is omitted.https://doi.org/10.1002/cam4.1477cerebal metastasesstereotactic radiotherapyresection cavitylocal controlneurocognitive benefit |
| spellingShingle | Stephanie E. Combs Angelika Bilger Christian Diehl Eva Bretzinger Hannah Lorenz Oliver Oehlke Hanno M. Specht Anna Kirstein Anca‐Ligia Grosu Multicenter analysis of stereotactic radiotherapy of the resection cavity in patients with brain metastases Cancer Medicine cerebal metastases stereotactic radiotherapy resection cavity local control neurocognitive benefit |
| title | Multicenter analysis of stereotactic radiotherapy of the resection cavity in patients with brain metastases |
| title_full | Multicenter analysis of stereotactic radiotherapy of the resection cavity in patients with brain metastases |
| title_fullStr | Multicenter analysis of stereotactic radiotherapy of the resection cavity in patients with brain metastases |
| title_full_unstemmed | Multicenter analysis of stereotactic radiotherapy of the resection cavity in patients with brain metastases |
| title_short | Multicenter analysis of stereotactic radiotherapy of the resection cavity in patients with brain metastases |
| title_sort | multicenter analysis of stereotactic radiotherapy of the resection cavity in patients with brain metastases |
| topic | cerebal metastases stereotactic radiotherapy resection cavity local control neurocognitive benefit |
| url | https://doi.org/10.1002/cam4.1477 |
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