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Clinical & Experimental Metastasis
Published in: Clinical & Experimental Metastasis 3/2020

01-06-2020 | Metastasis | Research Paper

Single-fraction radiosurgery versus fractionated stereotactic radiotherapy in patients with brain metastases: a comparative study

Authors: Maxime Loo, Yvan Pin, Alicia Thierry, Jean-Baptiste Clavier

Published in: Clinical & Experimental Metastasis | Issue 3/2020

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Abstract

To compare the local control and brain radionecrosis in patients with brain metastasis primarily treated by single-fraction radiosurgery (SRS) or hypofractionated stereotactic radiotherapy (HFSRT). Between January 2012 and December 2017, 179 patients with only 1–3 brain metastases (total: 287) primarily treated by SRS (14 Gy) or HFSRT (23.1 Gy in 3 fractions of 7.7 Gy, every other day) were retrospectively analyzed in a single center. Follow-up imaging data were available in 152 patients with 246 lesions. The corresponding Biological Effective Dose (BED) were 33.6 Gy and 40.9 Gy respectively for SRS and HFSRT group, assuming an α/β of 10 Gy. Local control (LC) and risk of radionecrosis (RN) were calculated by the Kaplan–Meier method. The actuarial local control rates at 6 and 12 months were 94% and 88.1% in SRS group, and 87.6% and 78.4%, in HFSRT group (p = 0.06), respectively. Only the total volume of edema was associated with worse LC (p = 0.01, HR 1.02, 95% CI [1.004–1.03]) in multivariate analysis. Brain radionecrosis occurred in 1 lesion in SRS group and 9 in HFSRT group. Median time to necrosis was 5.5 months (range 1–9). Only the volume of GTV was associated with RN (p = 0.02, HR 1.09, 95% CI [1.01–1.18]) in multivariate analysis. Multi-fraction SRT dose of 23.31 Gy in 3 fractions has similar efficacy to single-fraction SRT dose of 14 Gy in patients with brain metastases. A slightly higher occurrence of radionecrosis appeared in HFSRT group.
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Metadata
Title
Single-fraction radiosurgery versus fractionated stereotactic radiotherapy in patients with brain metastases: a comparative study
Authors
Maxime Loo
Yvan Pin
Alicia Thierry
Jean-Baptiste Clavier
Publication date
01-06-2020
Publisher
Springer Netherlands
Published in
Clinical & Experimental Metastasis / Issue 3/2020
Print ISSN: 0262-0898
Electronic ISSN: 1573-7276
DOI
https://doi.org/10.1007/s10585-020-10031-5

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