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Single fraction stereotactic radiosurgery for multiple brain metastases.

Publication ,  Journal Article
Limon, D; McSherry, F; Herndon, J; Sampson, J; Fecci, P; Adamson, J; Wang, Z; Yin, F-F; Floyd, S; Kirkpatrick, J; Kim, GJ
Published in: Adv Radiat Oncol
2017

INTRODUCTION: Due to the neurocognitive side effects of whole brain radiation therapy (WBRT), stereotactic radiosurgery (SRS) is being used with increasing frequency. The use of SRS is expanding for patients with multiple (>4) brain metastases (BM). This study summarizes our institutional experience with single-fraction, linear-accelerator-based SRS for multiple BM. METHODS AND MATERIALS: All patients who were treated between January 1, 2013, and September 30, 2015, with single-fraction SRS for ≥4 BM were included in this institutional review board-approved, retrospective, single-institution study. Patients were treated with linear accelerator-based image guided SRS. RESULTS: A total of 59 patients with ≥4 BM were treated with single-fraction SRS. The median follow-up was 15.2 months, and the median overall survival for the entire cohort was 5.8 months. The median number of treated lesions per patient was 5 (range, 4-23). Per patient, the median planning target volume (PTV) was 4.8 cc (range, 0.7-28.8 cc). The prescribed dose across all 380 BM for the 59 patients ranged from 7 to 20 Gy. The median of the mean dose to the total PTV was 19.5 Gy. Although the number of treated lesions (4-5 vs ≥6) did not influence survival, better survival was noted for a total PTV <10 cc versus ≥10 cc (7.1 vs 4.2 months, respectively; P = .0001). A mean dose of ≥19 Gy to the entire PTV was also associated with increased survival (6.6 vs 5.0 months, respectively; P = .0172). Patients receiving a dose of >12 Gy to ≥10 cc of normal brain had worse survival (5.1 vs 8.6 months, respectively; P = .0028). CONCLUSION: In single-fraction SRS for patients with multiple BM, smaller total tumor volume, higher total dose, and lower volume of normal brain receiving >12 Gy were associated with increased survival. These data suggest that using SRS for the treatment of multiple BM is efficacious and that outcomes may be affected more by total tumor volume than by the number of lesions.

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Published In

Adv Radiat Oncol

DOI

ISSN

2452-1094

Publication Date

2017

Volume

2

Issue

4

Start / End Page

555 / 563

Location

United States

Related Subject Headings

  • 3211 Oncology and carcinogenesis
 

Citation

APA
Chicago
ICMJE
MLA
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Limon, D., McSherry, F., Herndon, J., Sampson, J., Fecci, P., Adamson, J., … Kim, G. J. (2017). Single fraction stereotactic radiosurgery for multiple brain metastases. Adv Radiat Oncol, 2(4), 555–563. https://doi.org/10.1016/j.adro.2017.09.002
Limon, Dror, Frances McSherry, James Herndon, John Sampson, Peter Fecci, Justus Adamson, Zhiheng Wang, et al. “Single fraction stereotactic radiosurgery for multiple brain metastases.Adv Radiat Oncol 2, no. 4 (2017): 555–63. https://doi.org/10.1016/j.adro.2017.09.002.
Limon D, McSherry F, Herndon J, Sampson J, Fecci P, Adamson J, et al. Single fraction stereotactic radiosurgery for multiple brain metastases. Adv Radiat Oncol. 2017;2(4):555–63.
Limon, Dror, et al. “Single fraction stereotactic radiosurgery for multiple brain metastases.Adv Radiat Oncol, vol. 2, no. 4, 2017, pp. 555–63. Pubmed, doi:10.1016/j.adro.2017.09.002.
Limon D, McSherry F, Herndon J, Sampson J, Fecci P, Adamson J, Wang Z, Yin F-F, Floyd S, Kirkpatrick J, Kim GJ. Single fraction stereotactic radiosurgery for multiple brain metastases. Adv Radiat Oncol. 2017;2(4):555–563.
Journal cover image

Published In

Adv Radiat Oncol

DOI

ISSN

2452-1094

Publication Date

2017

Volume

2

Issue

4

Start / End Page

555 / 563

Location

United States

Related Subject Headings

  • 3211 Oncology and carcinogenesis