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01-11-2014 | Clinical Study

Local control after fractionated stereotactic radiation therapy for brain metastases

Authors: Selvan Rajakesari, Nils D. Arvold, Rachel B. Jimenez, Laura W. Christianson, Margaret C. Horvath, Elizabeth B. Claus, Alexandra J. Golby, Mark D. Johnson, Ian F. Dunn, Eudocia Q. Lee, Nancy U. Lin, Scott Friesen, Edward G. Mannarino, Matthew Wagar, Fred L. Hacker, Stephanie E. Weiss, Brian M. Alexander

Published in: Journal of Neuro-Oncology | Issue 2/2014

Abstract

Stereotactic radiosurgery (SRS) is frequently used in the management of brain metastases, but concerns over potential toxicity limit applications for larger lesions or those in eloquent areas. Fractionated stereotactic radiation therapy (SRT) is often substituted for SRS in these cases. We retrospectively analyzed the efficacy and toxicity outcomes of patients who received SRT at our institution. Seventy patients with brain metastases treated with SRT from 2006–2012 were analyzed. The rates of local and distant intracranial progression, overall survival, acute toxicity, and radionecrosis were determined. The SRT regimen was 25 Gy in 5 fractions among 87 % of patients. The most common tumor histologies were non-small cell lung cancer (37 %), breast cancer (20 %) and melanoma (20 %), and the median tumor diameter was 1.7 cm (range 0.4–6.4 cm). Median survival after SRT was 10.7 months. Median time to local progression was 17 months, with a local control rate of 68 % at 6 months and 56 % at 1 year. Acute toxicity was seen in 11 patients (16 %), mostly grade 1 or 2 with the most common symptom being mild headache. Symptomatic radiation-induced treatment change was seen on follow-up MRIs in three patients (4.3 %). SRT appears to be a safe and reasonably effective technique to treat brain metastases deemed less suitable for SRS, though dose intensification strategies may further improve local control.

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Title: Local control after fractionated stereotactic radiation therapy for brain metastases
Authors: Selvan Rajakesari
Nils D. Arvold
Rachel B. Jimenez
Laura W. Christianson
Margaret C. Horvath
Elizabeth B. Claus
Alexandra J. Golby
Mark D. Johnson
Ian F. Dunn
Eudocia Q. Lee
Nancy U. Lin
Scott Friesen
Edward G. Mannarino
Matthew Wagar
Fred L. Hacker
Stephanie E. Weiss
Brian M. Alexander
Publication date: 01-11-2014
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 2/2014
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-014-1556-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Local control after fractionated stereotactic radiation therapy for brain metastases

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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