Multidose Stereotactic Radiosurgery (9 Gy × 3) of the Postoperative Resection Cavity for Treatment of Large Brain Metastases

Minniti, Giuseppe; Esposito, Vincenzo; Clarke, Enrico; Scaringi, Claudia; Lanzetta, Gaetano; Salvati, Maurizio; Raco, Antonino; Bozzao, Alessandro; Enrici, Riccardo Maurizi

doi:10.1016/j.ijrobp.2013.03.037

Cited by 193 publications

(124 citation statements)

References 23 publications

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“…The risk of radionecrosis following postoperative SRS seems higher (9%-17.5%) 47,48 than that reported by the EORTC study with WBRT following either surgery or radiosurgery (2.6%), and could increase over time (7% at 1 y and 16% at 2 y).…”

Section: Stereotactic Radiosurgery/stereotactic Fractionated Radiothementioning

confidence: 67%

Diagnosis and treatment of brain metastases from solid tumors: guidelines from the European Association of Neuro-Oncology (EANO)

Soffietti

Abacıoğlu²,

Baumert³

et al. 2017

Neuro-Oncology

422

338

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The management of patients with brain metastases has become a major issue due to the increasing frequency and complexity of the diagnostic and therapeutic approaches. In 2014, the European Association of NeuroOncology (EANO) created a multidisciplinary Task Force to draw evidence-based guidelines for patients with brain metastases from solid tumors. Here, we present these guidelines, which provide a consensus review of evidence and recommendations for diagnosis by neuroimaging and neuropathology, staging, prognostic factors, and different treatment options. Specifically, we addressed options such as surgery, stereotactic radiosurgery/stereotactic fractionated radiotherapy, whole-brain radiotherapy, chemotherapy and targeted therapy (with particular attention to brain metastases from non-small cell lung cancer, melanoma and breast and renal cancer), and supportive care. Key wordsbrain metastases | chemotherapy | neuroimaging | neuropathology | stereotactic radiosurgery/stereotactic fractionated radiotherapy | supportive care | surgery | targeted therapy | whole-brain radiation therapy

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Section: Stereotactic Radiosurgery/stereotactic Fractionated Radiothementioning

confidence: 67%

Diagnosis and treatment of brain metastases from solid tumors: guidelines from the European Association of Neuro-Oncology (EANO)

Soffietti

Abacıoğlu²,

Baumert³

et al. 2017

Neuro-Oncology

422

338

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“…The same group published their experience using HF-SRS to treat postoperative resection cavities of large brain metastases. 44 …”

Section: Neurooncologymentioning

confidence: 99%

The radiosurgery fractionation quandary: single fraction or hypofractionation?

et al. 2017

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Stereotactic radiosurgery (SRS), typically administered in a single session, is widely employed to safely, efficiently, and effectively treat small intracranial lesions. However, for large lesions or those in close proximity to critical structures, it can be difficult to obtain an acceptable balance of tumor control while avoiding damage to normal tissue when single-fraction SRS is utilized. Treating a lesion in 2 to 5 fractions of SRS (termed "hypofractionated SRS" [HF-SRS]) potentially provides the ability to treat a lesion with a total dose of radiation that provides both adequate tumor control and acceptable toxicity. Indeed, studies of HF-SRS in large brain metastases, vestibular schwannomas, meningiomas, and gliomas suggest that a superior balance of tumor control and toxicity is observed compared with single-fraction SRS. Nonetheless, a great deal of effort remains to understand radiobiologic mechanisms for HF-SRS driving the dose-volume response relationship for tumors and normal tissues and to utilize this fundamental knowledge and the results of clinic studies to optimize HF-SRS. In particular, the application of HF-SRS in the setting of immunomodulatory cancer therapies offers special challenges and opportunities. Key wordsbrain metastases | hypofractionated stereotactic radiosurgery | normal tissue injury | radiobiology | stereotactic radiosurgery ii39 Kirkpatrick et al. Hypofractionated SRS

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“…Both single- and multi-dose SRS have been looked at as potential methods for delivering focal RT to the resection cavity. Prospective and retrospective evaluations of single- and multi-dose SRS to the resection cavity after brain metastasis surgery revealed excellent local control rates [24,25,26,27]. …”

Section: Radiotherapymentioning

confidence: 99%

Treatment of Brain Metastases

Lukas¹,

Gabikian²,

Garza³

et al. 2014

Oncology

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Brain metastases are associated with substantial morbidity and mortality. Key prognostic classification systems for brain metastases are reviewed. The role of surgery, particularly for single brain metastases, is discussed. This is followed by an overview of radiation, both whole brain and focal, in the treatment of brain metastases. Finally, we review examples of important concepts regarding the role of systemic therapy in the treatment of brain metastases.

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Multidose Stereotactic Radiosurgery (9 Gy × 3) of the Postoperative Resection Cavity for Treatment of Large Brain Metastases

Cited by 193 publications

References 23 publications

Diagnosis and treatment of brain metastases from solid tumors: guidelines from the European Association of Neuro-Oncology (EANO)

Diagnosis and treatment of brain metastases from solid tumors: guidelines from the European Association of Neuro-Oncology (EANO)

The radiosurgery fractionation quandary: single fraction or hypofractionation?

Treatment of Brain Metastases

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