Local Control Failure After Five-Fraction Stereotactic Radiosurgery Alone for Symptomatic Brain Metastasis From Squamous Cell Lung Carcinoma Despite 43 Gy to Gross Tumor Margin With Internal Steep Dose Increase and Tumor Shrinkage During Irradiation.

Kazuhiro Ohtakara, Kuniaki Tanahashi, Takeshi Kamomae, Eiji Ito, Kojiro Suzuki

Abstract readCase Reports

In one paragraph

Article in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it

0cells of the map it votes in

11citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kazuhiro OhtakaraDepartment of Radiation Oncology, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Yatomi, JPN.

Kuniaki TanahashiDepartment of Neurosurgery, Gifu Prefectural Tajimi Hospital, Tajimi, JPN.

Takeshi KamomaeRadioisotope Research Center, Nagoya University, Nagoya, JPN.

Eiji ItoDepartment of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, JPN.

Kojiro SuzukiDepartment of Radiology, Aichi Medical University, Nagakute, JPN.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Five-fraction (fr) stereotactic radiosurgery (SRS) is increasingly being applied to large brain metastases (BMs) >2-3 cm in diameter, for which 30-35 Gy is the commonly prescribed dose. Since 2018, to further enhance both safety and efficacy, we have limited the five-fr SRS to approximately ≤3 cm BMs and adopted our own modified dose prescription and distribution: 43 and 31 Gy cover the boundaries of the gross tumor volume (GTV) and 2 mm outside the GTV, respectively, along with a steep dose increase inside the GTV boundary, that is, an intentionally very inhomogeneous GTV dose. Herein, we describe a case of symptomatic BM treated with five-fr SRS using the above policy, which resulted in a maximum tumor response with nearly complete remission (nCR) followed by gradual tumor regrowth despite obvious tumor shrinkage during irradiation. A 71-year-old man who had previously undergone surgery for squamous cell carcinoma (SCC) of the lungs presented with right-sided hemiparesis attributed to the para-falcine BM (27 mm in maximum diameter, 5.38 cm

Indexed as

biological effective dosebrain metastasisfive fractionfractionationlinear-quadratic modellung cancerneuroendoscopynintedanibsquamous cell carcinomastereotactic radiosurgery

Identifiers

PMID37284398

DOI10.7759/cureus.38645

PMCPMC10241550

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