Efficacy of stereotactic radiosurgery as single or combined therapy for brain metastasis: A systematic review and meta-analysis

Rostampour, Nima; Rezaeian, Shahab; Sarbakhsh, Parvin; Meola, Antonio; Choupani, Jalal; Doosti-Irani, Amin; Nemati, Hossein; Almasi, Tinoosh; Badrigilan, Samireh; Chang, Steven D.

doi:10.1016/j.critrevonc.2023.104015

Cited by 2 publications

(1 citation statement)

References 73 publications

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“…Stereotactic radiotherapy treatment has become the recommended treatment for patients with one to four metastases, demonstrating equivalent survival and a lower risk of long‐term neurocognitive decline, compared with SRS plus WBRT. 3 , 4 , 5 Further, similar survival and preservation of neurocognitive function have been shown in patients receiving SRS SIMT for more than five metastases. 6 , 7 , 8 This modern treatment option is more efficient and less invasive compared with historical options of WBRT, surgery, radiosurgery, radiosensitizers, and chemotherapy.…”

Section: Introductionsupporting

confidence: 52%

Assessing the sensitivity and suitability of a range of detectors for SIMT PSQA

Dunn,

Tamborriello,

Subramanian

et al. 2024

J Applied Clin Med Phys

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PurposeSingle‐isocenter multi‐target intracranial stereotactic radiotherapy (SIMT) is an effective treatment for brain metastases with complex treatment plans and delivery optimization necessitating rigorous quality assurance. This work aims to assess five methods for quality assurance of SIMT treatment plans in terms of their suitability and sensitivity to delivery errors.MethodsSun Nuclear ArcCHECK and SRS MapCHECK, GafChromic EBT Radiochromic Film, machine log files, and Varian Portal Dosimetry were all used to measure 15 variations of a single SIMT plan. Variations of the original plan were created with Python. They comprised various degrees of systematic MLC offsets per leaf up to 2 mm, random per‐leaf variations with differing minimum and maximum magnitudes, simulated collimator, and dose miscalibrations (MU scaling). The erroneous plans were re‐imported into Eclipse and plan‐quality degradation was assessed by comparing each plan variation to the original clinical plan in terms of the percentage of clinical goals passing relative to the original plan. Each erroneous plan could be then ranked by the plan‐quality degradation percentage following recalculation in the TPS so that the effects of each variation could be correlated with γ pass rates and detector suitability.Results & conclusionsIt was found that 2%/1 mm is a good starting point for the ArcCHECK, Portal Dosimetry, and the SRS MapCHECK methods, respectively, and provides clinically relevant error detection sensitivity. Looser dose criteria of 5%/1 mm or 5%/1.5 mm are suitable for film dosimetry and log‐file‐based methods. The statistical methods explored can be expanded to other areas of patient‐specific QA and detector assessment.

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Section: Introductionsupporting

confidence: 52%

Assessing the sensitivity and suitability of a range of detectors for SIMT PSQA

Dunn,

Tamborriello,

Subramanian

et al. 2024

J Applied Clin Med Phys

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Brain Metastases from Thyroid Carcinoma: Prognostic Factors and Outcomes

Esmaeilzadeh,

Atallah,

Müller

et al. 2024

Cancers

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Intracranial metastases from thyroid cancer are rare. Although the prognosis of thyroid cancer patients is generally favorable, the prognosis of patients with intracranial metastases from thyroid cancer has been considered unfavorable owing to lower survival rates among such patients compared to those without intracranial involvement. Many questions about their management remain unclear. The aim of the present study was to analyze the characteristics, treatment modalities, and outcomes of patients with brain metastases from thyroid cancer. Among 4320 patients with thyroid cancer recorded in our institutional database over a 30-year period, the data of 20 patients with brain metastasis were retrospectively collected and analyzed. The clinical characteristics, histological type of primary cancer and metastatic brain tumor, additional previous distant metastasis, treatment modalities, locations and characteristics on radiologic findings, time interval between the first diagnosis of primary thyroid cancer and brain metastasis, and survival were analyzed. Among our patient cohort, the mean age at initial diagnosis was 59.3 ± 14.1 years, and at the manifestation of diagnosis of cerebral metastasis, the mean age was found to be 64.8 ± 14.9 years. The histological types of primary thyroid cancer were identified as papillary in ten patients, follicular in seven, and poorly differentiated carcinoma in three. The average interval between the diagnosis of thyroid cancer and brain metastasis was 63.4 ± 58.4 months (range: 0–180 months). Ten patients were identified as having a single intracranial lesion, and ten patients were found to have multiple lesions. Surgical resection was primarily performed in fifteen patients, and whole-brain radiotherapy, radiotherapy, or tyrosine kinase inhibitors were applied in the remaining five patients. The overall median survival time was 15 months after the diagnosis of BMs from TC (range: 1–252 months). Patients with thyroid cancer can develop brain metastasis even many years after the diagnosis of the primary tumor. The results of our study demonstrate increased overall survival in patients younger than 60 years of age at the time of diagnosis of brain metastasis. There was no difference in survival between patients with brain metastasis from papillary carcinoma and those with follicular thyroid carcinoma.

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Efficacy of stereotactic radiosurgery as single or combined therapy for brain metastasis: A systematic review and meta-analysis

Cited by 2 publications

References 73 publications

Assessing the sensitivity and suitability of a range of detectors for SIMT PSQA

Assessing the sensitivity and suitability of a range of detectors for SIMT PSQA

Brain Metastases from Thyroid Carcinoma: Prognostic Factors and Outcomes

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