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Single-fraction radiosurgery versus fractionated stereotactic radiotherapy in patients with brain metastases: a comparative study.
- Source :
-
Clinical & experimental metastasis [Clin Exp Metastasis] 2020 Jun; Vol. 37 (3), pp. 425-434. Date of Electronic Publication: 2020 Mar 17. - Publication Year :
- 2020
-
Abstract
- To compare the local control and brain radionecrosis in patients with brain metastasis primarily treated by single-fraction radiosurgery (SRS) or hypofractionated stereotactic radiotherapy (HFSRT). Between January 2012 and December 2017, 179 patients with only 1-3 brain metastases (total: 287) primarily treated by SRS (14 Gy) or HFSRT (23.1 Gy in 3 fractions of 7.7 Gy, every other day) were retrospectively analyzed in a single center. Follow-up imaging data were available in 152 patients with 246 lesions. The corresponding Biological Effective Dose (BED) were 33.6 Gy and 40.9 Gy respectively for SRS and HFSRT group, assuming an α/β of 10 Gy. Local control (LC) and risk of radionecrosis (RN) were calculated by the Kaplan-Meier method. The actuarial local control rates at 6 and 12 months were 94% and 88.1% in SRS group, and 87.6% and 78.4%, in HFSRT group (p = 0.06), respectively. Only the total volume of edema was associated with worse LC (p = 0.01, HR 1.02, 95% CI [1.004-1.03]) in multivariate analysis. Brain radionecrosis occurred in 1 lesion in SRS group and 9 in HFSRT group. Median time to necrosis was 5.5 months (range 1-9). Only the volume of GTV was associated with RN (p = 0.02, HR 1.09, 95% CI [1.01-1.18]) in multivariate analysis. Multi-fraction SRT dose of 23.31 Gy in 3 fractions has similar efficacy to single-fraction SRT dose of 14 Gy in patients with brain metastases. A slightly higher occurrence of radionecrosis appeared in HFSRT group.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Biopsy
Brain diagnostic imaging
Brain radiation effects
Brain Neoplasms diagnostic imaging
Brain Neoplasms mortality
Brain Neoplasms secondary
Dose-Response Relationship, Radiation
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Necrosis diagnosis
Necrosis epidemiology
Necrosis etiology
Necrosis pathology
Positron Emission Tomography Computed Tomography
Progression-Free Survival
Radiation Injuries diagnosis
Radiation Injuries etiology
Radiation Injuries pathology
Radiosurgery adverse effects
Retrospective Studies
Risk Factors
Tumor Burden
Young Adult
Brain pathology
Brain Neoplasms radiotherapy
Dose Fractionation, Radiation
Radiation Injuries epidemiology
Radiosurgery methods
Subjects
Details
- Language :
- English
- ISSN :
- 1573-7276
- Volume :
- 37
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Clinical & experimental metastasis
- Publication Type :
- Academic Journal
- Accession number :
- 32185576
- Full Text :
- https://doi.org/10.1007/s10585-020-10031-5