TY - JOUR
T1 - Hypo-fractionated stereotactic radiotherapy alone using volumetric modulated arc therapy for patients with single, large brain metastases unsuitable for surgical resection
AU - Navarria, Pierina
AU - Pessina, Federico
AU - Cozzi, Luca
AU - Ascolese, Anna Maria
AU - De Rose, Fiorenza
AU - Fogliata, Antonella
AU - Franzese, Ciro
AU - Franceschini, Davide
AU - Tozzi, Angelo
AU - D'Agostino, Giuseppe
AU - Comito, Tiziana
AU - Iftode, Cristina
AU - Maggi, Giulia
AU - Reggiori, Giacomo
AU - Bello, Lorenzo
AU - Scorsetti, Marta
PY - 2016/6/2
Y1 - 2016/6/2
N2 - Background: Hypo-fractionated stereotactic radiotherapy (HSRT) is emerging as a valid treatment option for patients with single, large brain metastases (BMs). We analyzed a set of our patients treated with HSRT. The aim of this study was to evaluate local control (LC), brain distant progression (BDP), toxicity and overall survival (OS). Methods: From July 2011 to May 2015, 102 patients underwent HSRT consisting of 27Gy/3fractions for lesions 2.1-3 cm and 32Gy/4 fractions for lesions 3.1-5 cm. Local progression was defined as increase of the enhancing abnormality on MRI, and distant progression as new brain metastases outside the irradiated volume. Toxicity in terms of radio-necrosis was assessed using contrast enhanced T1MRI, T2 weighted-MRI and perfusion- MRI. Result: The median maximum diameter of BM was 2.9 cm (range 2.1-5 cm), the median gross target volume (GTV) was 16.3 cm3 and the median planning target volume (PTV) was 33.7 cm3 The median,1,2-year local control rate was 30 months, 96, 96 %; the median, 1-2-year rate of BDP was 24 months, 12, 24 %; the median,1,2-year OS was 14 months, 69, 33 %. KPS and controlled extracranial disease were associated with significant survival benefit (p
AB - Background: Hypo-fractionated stereotactic radiotherapy (HSRT) is emerging as a valid treatment option for patients with single, large brain metastases (BMs). We analyzed a set of our patients treated with HSRT. The aim of this study was to evaluate local control (LC), brain distant progression (BDP), toxicity and overall survival (OS). Methods: From July 2011 to May 2015, 102 patients underwent HSRT consisting of 27Gy/3fractions for lesions 2.1-3 cm and 32Gy/4 fractions for lesions 3.1-5 cm. Local progression was defined as increase of the enhancing abnormality on MRI, and distant progression as new brain metastases outside the irradiated volume. Toxicity in terms of radio-necrosis was assessed using contrast enhanced T1MRI, T2 weighted-MRI and perfusion- MRI. Result: The median maximum diameter of BM was 2.9 cm (range 2.1-5 cm), the median gross target volume (GTV) was 16.3 cm3 and the median planning target volume (PTV) was 33.7 cm3 The median,1,2-year local control rate was 30 months, 96, 96 %; the median, 1-2-year rate of BDP was 24 months, 12, 24 %; the median,1,2-year OS was 14 months, 69, 33 %. KPS and controlled extracranial disease were associated with significant survival benefit (p
KW - Brain metastases
KW - HSRT
KW - RapidArc
KW - Volumetric modulated arc therapy
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U2 - 10.1186/s13014-016-0653-3
DO - 10.1186/s13014-016-0653-3
M3 - Article
AN - SCOPUS:84979077000
VL - 11
JO - Radiation Oncology
JF - Radiation Oncology
SN - 1748-717X
IS - 1
M1 - 76
ER -