Editorial: The biological advantage of single-session radiosurgery

Kondziolka, Douglas

doi:10.3171/2013.4.jns13723

Cited by 4 publications

(2 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This approach spares or at least delays the neurocognitive effects and other acute toxicities associated with WBRT8 . Recently, multiple reports have suggested the use of SRS as the initial management for patients with a limited number of BM …”

Section: Introductionmentioning

confidence: 99%

Tumor volume and sphericity as predictors of local control after stereotactic radiosurgery for limited number (1‐4) brain metastases from nonsmall cell lung cancer

Kim

Lee

et al. 2020

Asia-Pac J Clncl Oncology

View full text Add to dashboard Cite

Aim:This study aims to evaluate the usage of brain metastases (BM) tumor volume and sphericity as prognostic factors in local control (LC) after stereotactic radiosurgery (SRS) for limited number (1-4) BM from nonsmall cell lung cancer (NSCLC). Methods:We retrospectively reviewed 80 patients, with 141 BM, who were treated with SRS from 2012 to 2017. Local failure was defined as an increase in lesion size after SRS. LC and overall survival (OS) were estimated using Kaplan-Meier method. The Cox proportional hazards model was used for univariate and multivariate analysis. Results:The median clinical and radiographic follow-up was 11.2 and 9.0 months, respectively.The median BM tumor volume was 0.31 cm 3 (0.01-21.64 cm 3 ) and the median tumor sphericity was 0.76 (0.39-0.95). The median LC of the entire cohort was 28.8 months. LC rate at last followup was achieved in 84.4% of patients (35.5% CR, 35.5% PR, and 13.5% SD). LC was 83.8% at 1 year and 56.3% at 2 years. On multivariate analysis, only sphericity (P < .001) and volume (P = .004) were found to be a strong predictor for LC. The median OS of the entire cohort was 24.1 months.On multivariate analysis, only GPA score was found to be a predictor for OS.Conclusion: BM tumor sphericity and volume were found to be strong predictors for LC. Tumor sphericity and volume should be taken into consideration when treating patients with BM and when designing future prospective studies and developing prognostic indices. K E Y W O R D Sbrain metastases, cyberknife, stereotactic radiosurgery, tumor sphericity, tumor volume

show abstract

Section: Introductionmentioning

confidence: 99%

Tumor volume and sphericity as predictors of local control after stereotactic radiosurgery for limited number (1‐4) brain metastases from nonsmall cell lung cancer

Kim

Lee

et al. 2020

Asia-Pac J Clncl Oncology

View full text Add to dashboard Cite

show abstract

“…Thus, it was expected that brain metastases of radioresistant primary tumors treated with HSFRT would show poorer local control than these treated with SRS. Indeed, a retrospective study with a small sample concluded that fractionated stereotactic radiotherapy was less effective in radioresistant tumors and recommended that radioresistant tumors should be treated in a single fraction if possible [ 8 , 9 ]. The linear quadratic model has been suggested to be incorrect for large dose fractions, because it does not take into account additional biological effects resulting from high dose on endothelial cells and tumor immunity.…”

Section: Introductionmentioning

confidence: 99%

Radiosurgery or hypofractionated stereotactic radiotherapy for brain metastases from radioresistant primaries (melanoma and renal cancer)

et al. 2018

View full text Add to dashboard Cite

BackgroundUntil 50% of patients with renal cancer or melanoma, develop brain metastases during the course of their disease. Stereotactic radiotherapy has become a standard of care for patients with a limited number of brain metastases. Given the radioresistant nature of melanoma and renal cancer, optimization of the fractionation of stereotactic radiotherapy is needed. The purpose of this retrospective study was to elucidate if hypofractionated stereotactic radiotherapy (HFSRT) impacts local control of brain metastases from radioresistant tumors such as melanoma and renal cancer, in comparison with radiosurgery (SRS).MethodsBetween 2012 and 2016, 193 metastases, smaller than 3 cm, from patients suffering from radioresistant primaries (melanoma and renal cancer) were treated with HFSRT or SRS. The primary outcome was local progression free survival (LPFS) at 6, 12 and 18 months. Overall survival (OS) and cerebral progression free survival (CPFS) were secondary outcomes, and were evaluated per patient. Objective response rate and radionecrosis incidence were also reported. The statistical analysis included a supplementary propensity score analysis to deal with bias induced by non-randomized data.ResultsAfter a median follow-up of 7.4 months, LPFS rates at 6, 12 and 18 months for the whole population were 83, 74 and 70%, respectively. With respect to fractionation, LPFS rates at 6, 12 and 18 months were 89, 79 and 73% for the SRS group and 80, 72 and 68% for the HFSRT group. The fractionation schedule was not statistically associated with LPFS (HR = 1.39, CI95% [0.65–2.96], p = 0.38). Time from planning MRI to first irradiation session longer than 14 days was associated with a poorer local control rate. Over this time, LPFS at 12 months was reduced from 86 to 70% (p = 0.009). Radionecrosis occurred in 7.1% for HFSRT treated metastases to 9.6% to SRS treated metastases, without any difference according to fractionation (p = 0.55). The median OS was 9.6 months. Six, 12 and 18 months CPFS rates were 54, 24 and 17%, respectively.ConclusionFractionation does not decrease LPFS. Even for small radioresistant brain metastases (< 3 cm), HFSRT, with 3 or 6 fractions, leads to an excellent local control rate of 72% at 1 year with a rate of 7.1% of radionecrosis. HFSRT is a safe and efficient alternative treatment to SRS.Electronic supplementary materialThe online version of this article (10.1186/s13014-018-1083-1) contains supplementary material, which is available to authorized users.

show abstract

The Prognostic Role of Tumor Volume in the Outcome of Patients with Single Brain Metastasis After Stereotactic Radiosurgery

et al. 2017

View full text Add to dashboard Cite

Editorial: The biological advantage of single-session radiosurgery

Cited by 4 publications

References 8 publications

Tumor volume and sphericity as predictors of local control after stereotactic radiosurgery for limited number (1‐4) brain metastases from nonsmall cell lung cancer

Tumor volume and sphericity as predictors of local control after stereotactic radiosurgery for limited number (1‐4) brain metastases from nonsmall cell lung cancer

Radiosurgery or hypofractionated stereotactic radiotherapy for brain metastases from radioresistant primaries (melanoma and renal cancer)

The Prognostic Role of Tumor Volume in the Outcome of Patients with Single Brain Metastasis After Stereotactic Radiosurgery

Contact Info

Product

Resources

About