Summary
This study evaluates the treatment of intracerebral brain metastases with single dose stereotactic radiosurgery in comparison to stereotactic fractionated radiotherapy (SFR). Twenty six patients with 41 lesions were evaluated. Thirty four lesions in 19 patients were treated with radiosurgery, and 7 lesions in 7 patients were treated with SFR. The radiosurgery group was treated with an average number of isocenters of 1.4, and an average of 9 arcs. The average dose was 2140cGy delivered to the 70% isodose line. The average volume of the lesions was 5.22 cc. The SFR group lesions received a mean dose to the indicated area delivered by 4 to 6 coplanar fields. The dose was 600 cGy per fraction, 2 to 3 fractions were given. The average volume of the treated lesions was 21.2 cc.
Follow-up extended from 2–18 months. Twenty five lesions of the radiosurgery group had image follow-up. The overall local control was seen in 92% of the patients. Six lesions of the SFR group had image follow-up, the local control was 83%. The small number in each group, the non-randomized nature of the study, and the relatively short follow-up preclude a definitive conclusion.
SFR may be the method of choice for large lesions surrounded by significant edema. The delivery of the dose in large fractions may obviate the transient acute reactions seen when radiosurgical dose is delivered to large lesions surrounded by edema. However, both forms of therapy have proven to be effective in the control of brain metastases.
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References
Adler JR, Cox RS, Kaplan I, Martin DP (1992) Stereotactic radiosurgical treatment of brain metastases. J Neurosurg 76: 444–449
Cairncross JG, Kim JH, Posner JB (1980) Radiation therapy for brain metastases. Ann Neurol 7: 529–541
Coffey RJ, Lunsford LD, Flickinger JC (1992) The role of radio-surgery in the treatment of malignant brain tumors. Stereotact Radiosurg V3N1: 231–244
Galicich JH (1981) Surgery of malignant brain tumors: Seminars in Neuro V1. Thieme-Stratton, New York, pp 159–159
Hendrickson FR (1977) The optimum schedule for palliative radiotherapy for metastatic brain cancer. Int J Radiat Onc Bio Phys 2: 165–168
Kurtz JM, Gelber R, Brady LW (1981) The palliation of brain metastases in a favorable patient population. A randomized clinical trial by the Radiation Therapy Oncology Group. Int J Radiat Onc Bio Phys 7: 891–895
Loeffler JS, Kooy HM, Wen PY, Fine HA, Mannarino EG, Tsai JS, Alexander E (1990) The treatment of recurrent brain metastases with stereotactic radiosurgery. J Clin Onc 8: 576–582
Order SE, Hellman S, Von Essen CF (1968) Improvement in quality of survival following whole brain irradiation for brain metastases. Radiology 91: 149–153
Patchell RA, Tibbs PA, Walsh JW (1990) A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 322: 494–500
Smalley SR, Schray MF, Laws ER, O’Gallon JR (1987) Adjuvant radiation therapy after surgical resection of solitary brain metastases: Association with pattern of failure and survival. Int J Radiat Onc Bio Phys 13: 1611–1616
Takakura K, Sano K, Hojo S, Hirano A (1982) Metastatic tumors of the central nervous system. Igaku-Shoin, Tokyo
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© 1993 Springer-Verlag Wien
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De Salles, A.A.F. et al. (1993). Comparison Between Radiosurgery and Stereotactic Fractionated Radiation for the Treatment of Brain Metastases. In: Meyerson, B.A., Broggi, G., Martin-Rodriguez, J., Ostertag, C., Sindou, M. (eds) Advances in Stereotactic and Functional Neurosurgery 10. Acta Neurochirurgica, vol 58. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9297-9_27
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DOI: https://doi.org/10.1007/978-3-7091-9297-9_27
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