CyberKnife Stereotactic Radiosurgery in brain metastases: A report from Latin America with literature review

Peña, Cuauhtémoc de la; Guajardo, Jorge H.; González, Mercedes; Gonzalez, Cesar A.; Cruz, Benjamín

doi:10.1016/j.rpor.2018.02.005

Cited by 10 publications

(5 citation statements)

References 35 publications

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“…The findings per group are discussed below. The studies which did not find any significant factors [31][32][33][34][35][36][37][38][39][40][41][42][43] were not included in these groups. Also, comparative studies that did not find any significant factors other than the treatment type [44][45][46][47][48][49][50][51][52][53][54] were not included in these groups and are not further discussed.…”

Section: Study Characteristicsmentioning

confidence: 99%

Factors associated with the local control of brain metastases: a systematic search and machine learning application

Kanakarajan,

De Baene,

Gehring

et al. 2024

BMC Med Inform Decis Mak

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Background Enhancing Local Control (LC) of brain metastases is pivotal for improving overall survival, which makes the prediction of local treatment failure a crucial aspect of treatment planning. Understanding the factors that influence LC of brain metastases is imperative for optimizing treatment strategies and subsequently extending overall survival. Machine learning algorithms may help to identify factors that predict outcomes. Methods This paper systematically reviews these factors associated with LC to select candidate predictor features for a practical application of predictive modeling. A systematic literature search was conducted to identify studies in which the LC of brain metastases is assessed for adult patients. EMBASE, PubMed, Web-of-Science, and the Cochrane Database were searched up to December 24, 2020. All studies investigating the LC of brain metastases as one of the endpoints were included, regardless of primary tumor type or treatment type. We first grouped studies based on primary tumor types resulting in lung, breast, and melanoma groups. Studies that did not focus on a specific primary cancer type were grouped based on treatment types resulting in surgery, SRT, and whole-brain radiotherapy groups. For each group, significant factors associated with LC were identified and discussed. As a second project, we assessed the practical importance of selected features in predicting LC after Stereotactic Radiotherapy (SRT) with a Random Forest machine learning model. Accuracy and Area Under the Curve (AUC) of the Random Forest model, trained with the list of factors that were found to be associated with LC for the SRT treatment group, were reported. Results The systematic literature search identified 6270 unique records. After screening titles and abstracts, 410 full texts were considered, and ultimately 159 studies were included for review. Most of the studies focused on the LC of the brain metastases for a specific primary tumor type or after a specific treatment type. Higher SRT radiation dose was found to be associated with better LC in lung cancer, breast cancer, and melanoma groups. Also, a higher dose was associated with better LC in the SRT group, while higher tumor volume was associated with worse LC in this group. The Random Forest model predicted the LC of brain metastases with an accuracy of 80% and an AUC of 0.84. Conclusion This paper thoroughly examines factors associated with LC in brain metastases and highlights the translational value of our findings for selecting variables to predict LC in a sample of patients who underwent SRT. The prediction model holds great promise for clinicians, offering a valuable tool to predict personalized treatment outcomes and foresee the impact of changes in treatment characteristics such as radiation dose.

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Section: Study Characteristicsmentioning

confidence: 99%

Factors associated with the local control of brain metastases: a systematic search and machine learning application

Kanakarajan,

De Baene,

Gehring

et al. 2024

BMC Med Inform Decis Mak

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“…The prescription dose was 21.1 (10-25.1) Gy Gamma Knife 6 mo First course Tamari et al [12] 2015 67 109 0.9 for SRS and 6.1 for SRT 24-30Gy/1-3f cyberknife 13.1 mo First course Croker et al [13] 2015 61 107 5.76 Median dose of 24 Linear Accelerators 21 mo Second course Murovic et al [14] 2017 150 --cyberknife 13 mo First course de le pena et al [15] 2017 49 152 6.71 20-26 CyberKnife 15.5 mo First course Sayan et al [16] 2019 recurrent brain multiple brain metastases. Therefore, we designed the workflow of the re-irradiation [21] (Fig.…”

Section: Mo First Coursementioning

confidence: 99%

Re-irradiation of multiple brain metastases using CyberKnife stereotactic radiotherapy

Zhou

Wu²,

Zhu³

et al. 2021

Medicine

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Introduction: Brain metastasis (BM) is the commonest adult intracranial malignancy and many patients with brain metastases require two course radiotherapy. Re-irradiation is frequently performed in Radiotherapy (RT) departments for multiple brain metastases.Patient concerns: We present a case of a 55-year-old male patient suffering from brain metastases, who had previously received whole-brain radiotherapy (WBRT) and first CyberKnife Stereotactic Radiotherapy (CKSRT) for metastases, presented with a recurrence of metastasis and new lesions in the brain.Diagnoses: An enhanced computed tomography (CT) scan of the brain revealed abnormalities with double-dosing of intravenous contrast that identified >10 lesions scattered in the whole brain.Interventions: Re-irradiation was performed using CKSRT. The patient was treated with 30 Gy in 5 fractions for new lesions and 25 Gy in 5 fractions for lesion that were locally recurrent and close to brainstem lesions.Outcome: The lesions were well-controlled, and the headache of the patient was significantly relieved one month after radiotherapy. The total survival time of the patients was 17 months from the beginning of the Cyberknife treatment. Conclusion:The present case report demonstrates that CyberKnife therapy plays a significant role in the repeated radiotherapy for multiple metastatic brain tumors. CKSRT can be used as a salvage method in recurrent multiple brain metastases.

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“…[5][6][7][8] Commonly, up to four brain metastases are regarded suitable targets for local therapy, such as stereotactic radiosurgery (SRS), stereotactic fractionated radiotherapy (SFRT) and surgical resection. [9][10][11] The latter is often supplemented by post-operative stereotactic radiotherapy, 12 while whole-brain radiotherapy (WBRT) is deferred until more widespread metastases become apparent. In case of negative prognostic factors, such as extensive and uncontrollable extracranial disease, WBRT or even best supportive care alone might be appropriate even in situations with up to four brain metastases.…”

Section: Background and Aimmentioning

confidence: 99%

Long-term survival results after treatment for oligometastatic brain disease

Nieder

Hintz

Popp

et al. 2020

Reports of Practical Oncology & Radiotherapy

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Aim: The aim of this study was to characterize the survival results of patients with up to four brain metastases after intense local therapy (primary surgery or stereotactic radiotherapy) if extracranial metastases were absent or limited to one site, e.g. the lungs.Background: Oligometastatic disease has repeatedly been reported to convey a favorable prognosis.Material and Methods: This retrospective study included 198 German and Norwegian patients treated with individualized approaches, always including brain radiotherapy.Information about age, extracranial spread, number of brain metastases, performance status and other variables was collected. Uni-and multivariate tests were performed.Results: Median survival was 16.5 months (single brain metastasis) and 9.8 months (2-4, comparable survival for 2, 3 and 4), respectively (p=0.001). After 5 years, 15 and 2% of the patients were still alive. In patients alive after 2 years, added median survival was 23 months and the probability of being alive 5 years after treatment was 26%. In multivariate analysis, extracranial metastases were not significantly associated with survival, while primary tumor control was.Conclusion: Long-term survival beyond 5 years is possible in a minority of patients with oligometastatic brain disease, in particular those with single brain metastasis. The presence of extracranial metastases to one site should not be regarded a barrier towards maximum brain-directed therapy.

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CyberKnife Stereotactic Radiosurgery in brain metastases: A report from Latin America with literature review

Abstract: CKRS achieves excellent overall survival and local control rates with low toxicity in patients with brain metastases.

Cited by 10 publications

References 35 publications

Factors associated with the local control of brain metastases: a systematic search and machine learning application

Factors associated with the local control of brain metastases: a systematic search and machine learning application

Re-irradiation of multiple brain metastases using CyberKnife stereotactic radiotherapy

Long-term survival results after treatment for oligometastatic brain disease

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