ArticleBMC cancer2012
Hypofractionated stereotactic radiotherapy of limited brain metastases: a single-centre individualized treatment approach.
Article in BMC cancer, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Optimal hypofractionated conformal radiotherapy for large brain metastases in patients with high risk factors: a single-institutional prospective study.Radiation oncology (London, England) · 2014Trial
- Adjuvant therapy after resection of brain metastases. Frameless image-guided LINAC-based radiosurgery and stereotactic hypofractionated radiotherapy.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2013Trial
- Comparison of 3 vs 5 Fraction Single Isocenter Radiosurgery for Brain Metastases.Advances in radiation oncology · 2026Article
- Hypofractionated stereotactic radiotherapy for brain metastases in lung cancer patients: dose‒response effect and toxicity.Discover oncology · 2024Article
- Stereotactic radiotherapy for brain oligometastases.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2022Review
- Single-fraction versus hypofractionated gamma knife radiosurgery for small metastatic brain tumors.Clinical & experimental metastasis · 2021Article
- Dosimetric differences between cesium-131 and iodine-125 brachytherapy for the treatment of resected brain metastases.Journal of contemporary brachytherapy · 2020Article
- Fractionated Stereotactic Radiation Therapy Using Volumetric Modulated Arc Therapy in Patients with Solitary Brain Metastases.BioMed research international · 2020Article
- The Expanding Role of Radiosurgery for Brain Metastases.Medicines (Basel, Switzerland) · 2018Review
- The role of radiosurgery in the acute management of fourth ventricle compression due to brain metastases.Surgical neurology international · 2018Article
- Adaptive hypofractionated gamma knife radiosurgery in the acute management of large thymic carcinoma brain metastases.Surgical neurology international · 2017Article
- Treatment of brain oligometastases with hypofractionated stereotactic radiotherapy utilising volumetric modulated arc therapy.Clinical & experimental metastasis · 2016Article
- Quantifying the trigger level of the vacuum surveillance system of the Gamma-Knife eXtend™ positioning system and evaluating the potential impact on dose delivery.Journal of radiosurgery and SBRT · 2016Article
- Local control after fractionated stereotactic radiation therapy for brain metastases.Journal of neuro-oncology · 2014Article
- Treatment of single or multiple brain metastases by hypofractionated stereotactic radiotherapy using helical tomotherapy.International journal of molecular sciences · 2014Article
- Fractionated stereotactic radiation therapy for intact brain metastases.Advances in radiation oncologyArticle
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7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundWe retrospectively report treatment results of our single-centre experience with hypofractionated stereotactic radiotherapy (hfSRT) of limited brain metastases in primary and recurrence disease situations. Our aim was to find the most effective and safe dose concept.
methodsFrom 04/2006 to 12/2010, 75 patients, with 108 intracranial metastases, were treated with hfSRT. 52 newly diagnosed metastases (48%), without up-front whole brain radiotherapy (WBRT), received hfSRT as a primary treatment. 56 metastases (52%) received a prior WBRT and were treated in this study in a recurrence situation. Main fractionation concepts used for primary hfSRT were 6-7x5 Gy (61.5%) and 5x6 Gy (19.2%), for recurrent hfSRT 7-10x4 Gy (33.9%) and 5-6x5 Gy (33.9%).
resultsMedian overall survival (OS) of all patients summed up to 9.1 months, actuarial 6-and 12-month-OS was 59% and 35%, respectively. Median local brain control (LC) was 11.9 months, median distant brain control (DC) 3.9 months and intracranial control (IC) 3.4 months, respectively. Variables with significant influence on OS were Gross Tumour Volume (GTV) (p = 0.019), the biological eqivalent dose (calculated on a 2 Gy single dose, EQD2, α/β = 10) < and ≥ median of 39 Gy (p = 0.012), extracerebral activity of the primary tumour (p < 0.001) and the steroid uptake during hfSRT (p = 0.03). LC was significantly influenced by the EQD2, ≤ and > 35 Gy (p = 0.004) in both uni- and multivariate Cox regression analysis. Median LC was 14.9 months for EQD2 >35 Gy and 3.4 months for doses ≤35 Gy, respectively. Early treatment related side effects were usually mild. Nevertheless, patients with a EQD2 >35 Gy had higher rates of toxicity (31%) than ≤35 Gy (8.3%, p=0.026).
conclusionComparing different dose concepts in hfSRT, a cumulative EQD2 of ≥35 Gy seems to be the most effective concept in patients with primary or recurrent limited brain metastases. Despite higher rates of only mild toxicity, this concept represents a safe treatment option.
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