Hypo-fractionated stereotactic radiotherapy alone using volumetric modulated arc therapy for patients with single, large brain metastases unsuitable for surgical resection

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Abstract

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

Original languageEnglish
Article number76
JournalRadiation Oncology
Volume11
Issue number1
DOIs
Publication statusPublished - Jun 2 2016

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Intensity-Modulated Radiotherapy
Radiotherapy
Neoplasm Metastasis
Brain
Survival
Magnetic Resonance Angiography
Radio
Necrosis

Keywords

  • Brain metastases
  • HSRT
  • RapidArc
  • Volumetric modulated arc therapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

@article{bd2ad758063942a2bf75e0363b98ac68,
title = "Hypo-fractionated stereotactic radiotherapy alone using volumetric modulated arc therapy for patients with single, large brain metastases unsuitable for surgical resection",
abstract = "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",
keywords = "Brain metastases, HSRT, RapidArc, Volumetric modulated arc therapy",
author = "Pierina Navarria and Federico Pessina and Luca Cozzi and Ascolese, {Anna Maria} and {De Rose}, Fiorenza and Antonella Fogliata and Ciro Franzese and Davide Franceschini and Angelo Tozzi and Giuseppe D'Agostino and Tiziana Comito and Cristina Iftode and Giulia Maggi and Giacomo Reggiori and Lorenzo Bello and Marta Scorsetti",
year = "2016",
month = "6",
day = "2",
doi = "10.1186/s13014-016-0653-3",
language = "English",
volume = "11",
journal = "Radiation Oncology",
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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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