Stereotactic radiosurgery (SRS) for brain metastases: a systematic review

Nieder, Carsten; Grosu, Anca L.; Gaspar, Laurie E.

doi:10.1186/1748-717x-9-155

Cited by 138 publications

(106 citation statements)

References 107 publications

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“…8 For framed SRS, 1-year local progression-free survival (PFS) was reported to be up to 70% to 90%, and median overall survival (OS) of 6 to 12 months. [9][10][11][12][13][14][15] The outcomes of frameless SRS have been reported only in limited series, with 1-year local control of 79% to 95%. 5,[16][17][18] Patient selection and tailor-made management are indeed challenging.…”

Section: New Knowledge Added By This Studymentioning

confidence: 99%

Frameless stereotactic radiosurgery for brain metastases: a review of outcomes and prognostic scores evaluation

et al. 2017

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Introduction: Stereotactic brain radiosurgery provides good local control in patients with limited brain metastases. A newly developed frameless system allows pain-free treatment. We reviewed the effectiveness of this frameless stereotactic brain radiosurgery and identified prognostic factors that may aid better patient selection. Methods:Medical records of patients with brain metastases treated with linear accelerator-based frameless stereotactic brain radiosurgery between January 2010 and July 2015 in a university affiliated hospital in Hong Kong were reviewed. Outcomes including local and distant brain control rate, progression-free survival, and overall survival were analysed. Prognostic factors were identified by univariable and multivariable analyses. Association of outcomes with four common prognostic scores was performed.Results: In this study, 64 patients with 94 lesions were treated with a median dose of 18 Gy (range, 12-22 Gy) in a single fraction. The median follow-up was 11.5 months. One-year actuarial local and distant brain control rates were 72% and 71%, respectively. The median overall survival was 13.0 months. On multivariable analysis, Karnofsky performance status score (>50 vs ≤50) and number of lesions (1-2 vs ≥3) were found to associate significantly with distinct brain progression-free survival (P=0.022, hazard ratio=0.20, 95% confidence interval 0.05-0.80 and P=0.003, hazard ratio=0.31, 95% confidence interval 0.14-0.68, respectively). Overall survival was

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Section: New Knowledge Added By This Studymentioning

confidence: 99%

Frameless stereotactic radiosurgery for brain metastases: a review of outcomes and prognostic scores evaluation

et al. 2017

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“…Brain metastases are a common oncological diagnosis1 and intracranial stereotactic radiosurgery (SRS) has evolved as an important modality of treatment/palliation for that disease 2, 3. It was demonstrated that even with multiple metastases the SRS treatment could provide reasonable local control,4, 5 and a multi‐institutional observational study suggested that clinical outcomes for patients with 5–10 individual metastases treated by SRS alone may be non‐inferior to those with 2–4 targets 6, 7.…”

Section: Introductionmentioning

confidence: 99%

A hybrid volumetric dose verification method for single‐isocenter multiple‐target cranial SRS

Ahmed

Kapatoes

Zhang

et al. 2018

J Applied Clin Med Phys

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A commercial semi‐empirical volumetric dose verification system (PerFraction [PF], Sun Nuclear Corp.) extracts multi‐leaf collimator positions from the electronic portal imaging device movies collected during a pre‐treatment run, while the rest of the delivered control point information is harvested from the accelerator log files. This combination is used to reconstruct dose on a patient CT dataset with a fast superposition/convolution algorithm. The method was validated for single‐isocenter multi‐target SRS VMAT treatments against absolute radiochromic film measurements in a cylindrical phantom. The targets ranged in size from 0.8 to 3.6 cm and in number from 3 to 10 per plan. A total of 17 films rotated at different angles around the cylinder axis were analyzed. Each of 27 total targets was intercepted by at least one film, and 2–4 different films were analyzed per plan. Film dose was always scaled to the ion chamber measurement in a high‐dose, low‐gradient area deliberately created at the isocenter. The planar dose agreement between PF and film using 3%(Global dose‐difference normalization)/1 mm gamma analysis was on average 99.2 ± 1.1%. The point dose difference in the low‐gradient area in the middle of every target was below 3%, while PF‐reconstructed and film dose centroids for individual targets showed submillimeter agreement when measured on a well aligned accelerator. Volumetrically, all voxels in all plans agreed between PF and the primary treatment planning system at the 3%/1 mm level. With proper understanding of its advantages and shortcomings, the tool can be applied to patient‐specific QA in routine radiosurgical clinical practice.

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“…Patients can be treated in a minimally invasive fashion and return to usual activities the next day. GKRS has found applications as a primary strategy or adjuvant therapy in a number of clinical fields including intracranial tumors, vascular malformations, psychiatric disorders, and functional disorders such as pain, movement disorder, and epilepsy (21)(22)(23)(24)(25). Despite risks of radiation-induced adverse effects, GKRS is now an indispensable neurosurgical tool, especially in cases where the lesion is too hard to approach with standard neurosurgery and the patient's condition not good enough to endure open surgery (26).…”

Section: Gamma Knife Radiosurgery (Gkrs)mentioning

confidence: 99%

Image-guided Stereotactic Neurosurgery: Practices and Pitfalls

Jung¹,

Kim²,

Kim³

et al. 2015

Journal of International Society for Simulation Surgery

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Image-guided neurosurgery (IGN) is a technique for localizing objects of surgical interest within the brain. In the past, its main use was placement of electrodes; however, the advent of computed tomography has led to a rebirth of IGN. Advances in computing techniques and neuroimaging tools allow improved surgical planning and intraoperative information. IGN influences many neurosurgical fields including neuro-oncology, functional disease, and radiosurgery. As development continues, several problems remain to be solved. This article provides a general overview of IGN with a brief discussion of future directions.

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Stereotactic radiosurgery (SRS) for brain metastases: a systematic review

Cited by 138 publications

References 107 publications

Frameless stereotactic radiosurgery for brain metastases: a review of outcomes and prognostic scores evaluation

Frameless stereotactic radiosurgery for brain metastases: a review of outcomes and prognostic scores evaluation

A hybrid volumetric dose verification method for single‐isocenter multiple‐target cranial SRS

Image-guided Stereotactic Neurosurgery: Practices and Pitfalls

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