ArticleRadiation oncology (London, England)2020
Brain metastases treated with hypofractionated stereotactic radiotherapy: 8 years experience after Cyberknife installation.
Article in Radiation oncology (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Surgical resection versus stereotactic radiosurgery for the treatment of brain metastases in the motor cortex; a meta-analysis and systematic review.Clinical & experimental metastasis · 2024Pooled it
- Factors associated with the local control of brain metastases: a systematic search and machine learning application.BMC medical informatics and decision making · 2024Pooled it
- Pooled it
- Radionecrosis risk and local control after CyberKnifeRadiation oncology (London, England) · 2026Article
- Review
- Management of critically located brain metastases in patients with precluded survival using customised double-dose prescription-based, adaptive accelerated staged radiosurgery: a long-term retrospective analysis.Radiation oncology (London, England) · 2025Article
- Stereotactic radiosurgery for patients with brain metastases: current principles, expanding indications and opportunities for multidisciplinary care.Nature reviews. Clinical oncology · 2025Review
- Investigating the impact of non-standard positioning on the accuracy of skull tracking algorithms using dual-panel imaging systems.Frontiers in oncology · 2024Article
- Outcomes Following Early Postoperative Adjuvant Radiosurgery for Brain Metastases.JAMA network open · 2023Article
- Article
- Feasibility of a simultaneously integrated boost concept for hypofractionated stereotactic radiotherapy of unresected brain metastases.Radiation oncology (London, England) · 2023Article
- Article
- Five-Fraction Stereotactic Radiotherapy for Brain Metastases-A Retrospective Analysis.Current oncology (Toronto, Ont.) · 2023Article
- Assessment of intra-fraction motion during frameless image guided Gamma Knife stereotactic radiosurgery.Physics and imaging in radiation oncology · 2023Article
- Hypofractionated Stereotactic Radiotherapy with CyberKnife for Large Arteriovenous Malformations and Arteriovenous Malformations Located in Eloquent Areas.Neurologia medico-chirurgica · 2022Article
- Brachytherapy for central nervous system tumors.Journal of neuro-oncology · 2022Review
- Comparison of Two Cyberknife Planning Approaches for Multiple Brain Metastases.Frontiers in oncology · 2022Article
- Network pharmacological analysis of active components of Xiaoliu decoction in the treatment of glioblastoma multiforme.Frontiers in genetics · 2022Article
- Outcomes of Hypofractionated Stereotactic Radiotherapy for Small and Moderate-Sized Brain Metastases: A Single-Institution Analysis.Frontiers in oncology · 2022Article
- Dose-Response Effect and Dose-Toxicity in Stereotactic Radiotherapy for Brain Metastases: A Review.Cancers · 2021Review
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHypofractionated stereotactic radiotherapy (HFSRT) is indicated for large brain metastases (BM) or proximity to critical organs (brainstem, chiasm, optic nerves, hippocampus). The primary aim of this study was to assess factors influencing BM local control after HFSRT. Then the effect of surgery plus HFSRT was compared with exclusive HFSRT on oncologic outcomes, including overall survival. MATERIALS AND
methodsRetrospective study conducted in Léon Bérard Cancer Center, included patients over 18 years-old with BM, secondary to a tumor proven by histology and treated by HFSRT alone or after surgery. Three different dose-fractionation schedules were compared: 27 Gy (3 × 9 Gy), 30 Gy (5 × 6 Gy) and 35 Gy (5 × 7 Gy), prescribed on isodose 80%. Primary endpoint were local control (LC). Secondary endpoints were overall survival (OS) and radionecrosis (RN) rate.
resultsA total of 389 patients and 400 BM with regular MRI follow-up were analyzed. There was no statistical difference between the different dose-fractionations. On multivariate analysis, surgery (p = 0.049) and size (< 2.5 cm) (p = 0.01) were independent factors improving LC. The 12 months LC was 87.02% in the group Surgery plus HFSRT group vs 73.53% at 12 months in the group HFSRT. OS was 61.43% at 12 months in the group Surgery plus HFSRT group vs 50.13% at 12 months in the group HFSRT (p < 0.0085). Prior surgery (OR = 1.86; p = 0.0028) and sex (OR = 1.4; p = 0.0139) control of primary tumor (OR = 0.671, p = 0.0069) and KPS < 70 (OR = 0.769, p = 0.0094) were independently predictive of OS. The RN rate was 5% and all patients concerned were symptomatic.
conclusionsThis study suggests that HFSRT is an efficient and well-tolerated treatment. The optimal dose-fractionation remains difficult to determine. Smaller size and surgery are correlated to LC. These results evidence the importance of surgery for larger BM (> 2.5 cm) with a poorer prognosis. Multidisciplinary committees and prospective studies are necessary to validate these observations.
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