Radiosurgery for Recurrent Brain Metastases after Whole-Brain Radiotherapy : Factors Affecting Radiation-Induced Neurological Dysfunction
Journal of Korean Neurosurgical Society
;
: 275-283, 2009.
Article
in English
| WPRIM
| ID: wpr-212261
ABSTRACT
OBJECTIVE:
We retrospectively analyzed survival, local control rate, and incidence of radiation toxicities after radiosurgery for recurrent metastatic brain lesions whose initial metastases were treated with whole-brain radiotherapy. Various radiotherapeutical indices were examined to suggest predictors of radiation-related neurological dysfunction.METHODS:
In 46 patients, total 100 of recurrent metastases (mean 2.2, ranged 1-10) were treated by CyberKnife radiosurgery at average dose of 23.1 Gy in 1 to 3 fractions. The median prior radiation dose was 32.7 Gy, the median time since radiation was 5.0 months, and the mean tumor volume was 12.4 cm3. Side effects were expressed in terms of radiation therapy oncology group (RTOG) neurotoxicity criteria.RESULTS:
Mass reduction was observed in 30 patients (65%) on MRI. After the salvage treatment, one-year progression-free survival rate was 57% and median survival was 10 months. Age (6 months) toxicity occurred in 21%, respectively. Less acute toxicity was observed with small tumors (<10 cm3, p=0.03), and less chronic toxicity occurred at lower cumulative doses (<100 Gy, p=0.004). "Radiation toxicity factor" (cumulative dose times tumor volume of <1,000 Gyxcm3) was a significant predictor of both acute and chronic CNS toxicities.CONCLUSION:
Salvage CyberKnife radiosurgery is effective for recurrent brain metastases in previously irradiated patients, but careful evaluation is advised in patients with large tumors and high cumulative radiation doses to avoid toxicity.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Recurrence
/
Brain
/
Incidence
/
Survival Rate
/
Retrospective Studies
/
Radiosurgery
/
Disease-Free Survival
/
Tumor Burden
/
Neoplasm Metastasis
Type of study:
Incidence study
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Journal of Korean Neurosurgical Society
Year:
2009
Type:
Article
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