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01-12-2021 | Metastasis | Original Article

Intraoperative radiotherapy with low-energy x-rays after neurosurgical resection of brain metastases—an Augsburg University Medical Center experience

Authors: Klaus-Henning Kahl, MD, Nikolaos Balagiannis, Michael Höck, Sabine Schill, Zoha Roushan, Ehab Shiban, Heiko Müller, Ute Grossert, Ina Konietzko, Björn Sommer, Christoph J. Maurer, Ansgar Berlis, Volkmar Heidecke, Tilman Janzen, Georg Stüben, MD

Published in: Strahlentherapie und Onkologie | Issue 12/2021

Abstract

Purpose

External-beam radiotherapy (EBRT) is the predominant method for localized brain radiotherapy (LBRT) after resection of brain metastases (BM). Intraoperative radiotherapy (IORT) with 50-kV x‑rays is an alternative way to focally irradiate the resection cavity after BM surgery, with the option of shortening the overall treatment time and limiting normal tissue irradiation.

Methods

We retrospectively analyzed the outcomes of all patients who underwent neurosurgical resection of BM and 50-kV x‑ray IORT between 2013 and 2020 at Augsburg University Medical Center.

Results

We identified 40 patients with 44 resected BM treated with 50-kV x‑ray IORT. Median diameter of the resected metastases was 2.8 cm (range 1.5–5.9 cm). Median applied dose was 20 Gy. All patients received standardized follow-up (FU) including 3‑monthly MRI of the brain. Mean FU was 14.4 months, with a median MRI FU for alive patients of 12.2 months. Median overall survival (OS) of all treated patients was 26.4 months (estimated 1‑year OS 61.6%). The observed local control (LC) rate of the resection cavity was 88.6% (estimated 1‑year LC 84.3%). Distant brain control (DC) was 47.5% (estimated 1‑year DC 33.5%). Only 25% of all patients needed WBI in the further course of disease. The observed radionecrosis rate was 2.5%.

Conclusion

IORT with 50-kV x‑rays is a safe and appealing way to apply LBRT after neurosurgical resection of BM, with low toxicity and excellent LC. Close MRI FU is paramount to detect distant brain failure (DBF) early.

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Title: Intraoperative radiotherapy with low-energy x-rays after neurosurgical resection of brain metastases—an Augsburg University Medical Center experience
Authors: Klaus-Henning Kahl, MD
Nikolaos Balagiannis
Michael Höck
Sabine Schill
Zoha Roushan
Ehab Shiban
Heiko Müller
Ute Grossert
Ina Konietzko
Björn Sommer
Christoph J. Maurer
Ansgar Berlis
Volkmar Heidecke
Tilman Janzen
Georg Stüben, MD
Publication date: 01-12-2021
Publisher: Springer Berlin Heidelberg
Keywords: Metastasis
Radiotherapy
Published in: Strahlentherapie und Onkologie / Issue 12/2021
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-021-01831-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intraoperative radiotherapy with low-energy x-rays after neurosurgical resection of brain metastases—an Augsburg University Medical Center experience

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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