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72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

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Stereotactic radiosurgery for brainstem metastases

Stereotaktische Radiochirurgie von Hirnstammmetastasen

Meeting Abstract

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  • presenting/speaker Daniel Rueß - Universitätsklinikum Köln, Klinik für Stereotaxie und funktionelle Neurochirurgie, Köln, Deutschland
  • Tim-Mathis Beutel - Universitätsklinikum Köln, Klinik für Stereotaxie und funktionelle Neurochirurgie, Köln, Deutschland
  • Harald Treuer - Universitätsklinikum Köln, Klinik für Stereotaxie und funktionelle Neurochirurgie, Köln, Deutschland
  • Martin Kocher - Universitätsklinikum Köln, Klinik für Stereotaxie und funktionelle Neurochirurgie, Köln, Deutschland
  • Veerle Visser-Vandewalle - Universitätsklinikum Köln, Klinik für Stereotaxie und funktionelle Neurochirurgie, Köln, Deutschland
  • Maximilian I. Ruge - Universitätsklinikum Köln, Klinik für Stereotaxie und funktionelle Neurochirurgie, Köln, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV079

doi: 10.3205/21dgnc080, urn:nbn:de:0183-21dgnc0808

Published: June 4, 2021

© 2021 Rueß et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Surgical options for treating brainstem metastases (BSM) are limited. As an alternative to local or whole brain radiation therapy, stereotactic radiosurgery (SRS) can be applied for the treatment of BSM. However, especially in brainstem the applied dose has to be balanced between toxicity and efficacy of treatment. Therefore, we evaluated safety and efficacy of Cyberknife®-SRS in BSM.

Methods: In this single centre retrospective series we included all patients between 2013 and 2018 with BSM who underwent single session SRS using Cyberknife® and a minimum dose of 18 Gy. Patient data were analyzed with Kaplan-Meier estimates in terms of local control using Response Assessment in Neuro-Oncology (RANO) criteria, overall survival (OS) and progression free survival (PFS). Preexisting symptoms were rated as improved, stable and deteriorated during follow-up.

Results: A total of 35 patients (f/m =20/15, median age 58, range 33-78 years) with 39 BSM were identified. Mean tumor volume was 1.56 ± 2.1 cm3 (range, 0.03 – 8.7 cm3), median marginal dose was 19.1 Gy (range, 18-20 Gy) and the prescription isodose was 65 % in all cases. Mean follow-up was 11.7 months (range, 1-77 months).

Symptoms improved in 29%, remain stable in 68%. One patient showed deterioration of hemiparesis due to radiation induced tissue reaction.

At 6 and 12 months follow-up actuarial local control was 100%, PFS was 60% and 20%, OS was 90%, respectively.

Conclusion: Our preliminary results show that Cyberknife SRS can be applied safely and effectively in patients harbouring BSM regarding local control.