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71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

Multisession radiosurgery (msRS) for brain metastases – a single-centre series

Hypofraktionierte Radiochirurgie bei Hirnmetastasen

Meeting Abstract

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  • presenting/speaker Susanne Fichte - Cyberknife Centrum Mitteldeutschland, Erfurt, Deutschland
  • Hans-Ulrich Herold - Cyberknife Centrum Mitteldeutschland, Erfurt, Deutschland
  • Gunnar Surber - Cyberknife Centrum Mitteldeutschland, Erfurt, Deutschland
  • Klaus Hamm - Cyberknife Centrum Mitteldeutschland, Erfurt, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocP053

doi: 10.3205/20dgnc343, urn:nbn:de:0183-20dgnc3434

Veröffentlicht: 26. Juni 2020

© 2020 Fichte et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Radiosurgery (RS) is a well-accepted therapeutic option for brain metastases and increasingly used even for multiple metastases. However, large brain metastases or those in critical locations may not be amenable to single-session treatment. In these cases, multisession radiosurgery (msRS) in 3-5 fractions may be an alternative. We present our series of patients treated with multisession image-guided robotic radiosurgery.

Methods: Patients treated for brain metastases with multisession radiosurgery between November 2012 and March 2019 were analyzed retrospectively. Metastases with prior local therapy (surgery and/or focal radiotherapy except whole-brain radiotherapy) were excluded from analysis. Patient data, planning details and imaging were analyzed. For follow-up, contrast-enhanced MRI was fused to the initial imaging. Tumor response was evaluated and local control rate was assessed. Additionally, regional progression (new brain metastases) was documented. Kaplan-Meier estimation was used for statistical analysis of survival and local progression-free survival.

Results: 70 patients underwent 72 courses of multisession radiosurgery in 3-5 fractions (median 3). Mean time of follow-up after the first treatment was 13,1 (0,2-82,7) months. Overall survival was 63 % and 37% at 6 and 12 months, respectively. At least one radiographic follow-up was available for 45 treatments. Local control rate was 95%, 92% and 74% at 3, 6 and 12 months. 23 patients had regional progression after a mean time of 10,2 (1,6-39,4) months of whom 12 were treated with repeated radiosurgery.

Conclusion: msRS is a treatment option for brain metastases with a good rate of local control when single-session radiosurgery is not feasible, avoiding or postponing WBRT.