ABSTRACT
Objective: Stereotactic radiotherapy [SRT] has been increasingly used for treatment of brain metastases in recent years. The goal of this study was to evaluate the clinical outcomes in patients with brain metastases treated with LINAC-based SRT
Methods: Patients who underwent SRT at our institution between 2013 and 2017 were retrospectively analyzed. Treatment plans were generated using either iPlan stereotactic treatment planning system [Brainlab Ag, Feldkirchen, Germany] or Eclipse V11.0.47 [Varian Medical Systems, Palo Alto, CA, USA] and patients were treated on a TrueBeam machine equipped with a robotic couch. The treatment response was assessed using RANOBM criteria. The primary endpoint was local control. Secondary endpoints were distant brain control, overall survival and treatment toxicity
Results: Fifty-six patients [28 males and 28 females] with 100 lesions were identified for this study from July 2013 to November 2017. The median age at the time of SRT was 65 years [range 16-86]. The most common histologies were lung [66percent] and breast [26percent]. Seventeen lesions [17percent] were treated postoperatively. Median GPA score [graded prognostic assessment] was 2.5.Treatment regimens consisted of: 1 fraction [median dose = 20 Gy], 3 fractions [median dose = 27 Gy], 5 fractions [median dose = 30 Gy] and 6 fractions [median dose = 30 Gy] in 27percent, 18percent, 41percent and 14percent of the lesions respectively. The median GTV size was 2.44cc [range 0.1-119.67cc] and the median PTV size was 5.03cc [range 0.32-197.22cc]. At a median follow-up of 9.4 months, 7 patients recurred locally. The 1-year local control rate was 88percent and the mean local control was 33 months. The 1-year and mean distant brain control were 45percent and 16.8 months respectively and the 1-year and mean overall survival were 70percent and 29.5 months respectively. A GPA score > 2 was significantly associated with better overall survival than a GPA score
Conclusion: Our institution experience showed that LINAC-based SRT is an effective local ablative treatment for brain metastases with an excellent toxicity profile
ABSTRACT
To compare the national growth monitoring data with the National Centre for Health Statistics [NCHS] growth standards, which is currently used in the Kingdom of Saudi Arabia [KSA]. A cross sectional study following World Health Organization criteria in determining sample size was adopted, whereby 24,000 children from 5 regions were selected to be the desired sample. One hundred and two Primary Health Care centers were also selected randomly from the 5 regions, from where the sample was drawn. A special questionnaire was designed for the data collection. A pilot study was carried out to test the study instruments. Weight, height and head circumference were measured by standard procedures. This data was compared with the National Centre for Health Statistics [NCHS] data. The total number of children examined was 23,821, 11,913 boys and 11,908 girls, they were drawn from 102 health centers selected randomly. Comparing different percentiles for Saudi and NCHS data, there was a significant difference between the Saudi and American children. In order to ensure a correct follow up for our children in KSA, the national figures are more appropriate to follow than the NCHS data