Artikel
Multisession radiosurgery (msRS) for brain metastases – a single-centre series
Hypofraktionierte Radiochirurgie bei Hirnmetastasen
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Veröffentlicht: | 26. Juni 2020 |
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Gliederung
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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.