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Outcomes in Patients With 4 to 10 Brain Metastases Treated With Dose-Adapted Single-Isocenter Multitarget Stereotactic Radiosurgery: A Prospective Study.

Publication ,  Journal Article
Kim, GJ; Buckley, ED; Herndon, JE; Allen, KJ; Dale, TS; Adamson, JD; Lay, L; Giles, WM; Rodrigues, AE; Wang, Z; Kelsey, CR; Torok, JA ...
Published in: Adv Radiat Oncol
2021

PURPOSE: To examine the effectiveness and safety of single-isocenter multitarget stereotactic radiosurgery using a volume-adapted dosing strategy in patients with 4 to 10 brain metastases. METHODS AND MATERIALS: Adult patients with 4 to 10 brain metastases were eligible for this prospective trial. The primary endpoint was overall survival. Secondary endpoints were local recurrence, distant brain failure, neurologic death, and rate of adverse events. Exploratory objectives were neurocognition, quality of life, dosimetric data, salvage rate, and radionecrosis. Dose was prescribed in a single fraction per RTOG 90-05 or as 5 Gy × 5 fractions for lesions ≥3 cm diameter, lesions involving critical structures, or single-fraction brain V12Gy >20 mL. RESULTS: Forty patients were treated with median age of 61 years, Karnofsky performance status 90, and 6 brain metastases. Twenty-two patients survived longer than expected from the time of protocol SRS, with 1 living patient who has not reached that milestone. Median overall survival was 8.1 months with a 1-year overall survival of 35.7%. The 1-year local recurrence rate was 5% (10 of 204 of evaluable lesions) in 12.5% (4 of 32) of the patients. Distant brain failure was observed in 19 of 32 patients with a 1-year rate of 35.8%. Grade 1-2 headache was the most common complaint, with no grade 3-5 treatment-related adverse events. Radionecrosis was observed in only 5 lesions, with a 1-year rate of 1.5%. Rate of neurologic death was 20%. Neurocognition and quality of life did not significantly change 3 months after SRS compared with pretreatment. CONCLUSIONS: These results suggest that volume-adapted dosing single-isocenter multitarget stereotactic radiosurgery is an effective and safe treatment for patients with 4 to 10 brain metastases.

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Published In

Adv Radiat Oncol

DOI

ISSN

2452-1094

Publication Date

2021

Volume

6

Issue

6

Start / End Page

100760

Location

United States

Related Subject Headings

  • 3211 Oncology and carcinogenesis
 

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Chicago
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MLA
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Kim, G. J., Buckley, E. D., Herndon, J. E., Allen, K. J., Dale, T. S., Adamson, J. D., … Kirkpatrick, J. P. (2021). Outcomes in Patients With 4 to 10 Brain Metastases Treated With Dose-Adapted Single-Isocenter Multitarget Stereotactic Radiosurgery: A Prospective Study. Adv Radiat Oncol, 6(6), 100760. https://doi.org/10.1016/j.adro.2021.100760
Kim, Grace J., Evan D. Buckley, James E. Herndon, Karen J. Allen, Tyketra S. Dale, Justus D. Adamson, Lam Lay, et al. “Outcomes in Patients With 4 to 10 Brain Metastases Treated With Dose-Adapted Single-Isocenter Multitarget Stereotactic Radiosurgery: A Prospective Study.Adv Radiat Oncol 6, no. 6 (2021): 100760. https://doi.org/10.1016/j.adro.2021.100760.
Kim GJ, Buckley ED, Herndon JE, Allen KJ, Dale TS, Adamson JD, et al. Outcomes in Patients With 4 to 10 Brain Metastases Treated With Dose-Adapted Single-Isocenter Multitarget Stereotactic Radiosurgery: A Prospective Study. Adv Radiat Oncol. 2021;6(6):100760.
Kim, Grace J., et al. “Outcomes in Patients With 4 to 10 Brain Metastases Treated With Dose-Adapted Single-Isocenter Multitarget Stereotactic Radiosurgery: A Prospective Study.Adv Radiat Oncol, vol. 6, no. 6, 2021, p. 100760. Pubmed, doi:10.1016/j.adro.2021.100760.
Kim GJ, Buckley ED, Herndon JE, Allen KJ, Dale TS, Adamson JD, Lay L, Giles WM, Rodrigues AE, Wang Z, Kelsey CR, Torok JA, Chino JP, Fecci PE, Sampson JH, Anders CK, Floyd SR, Yin F-F, Kirkpatrick JP. Outcomes in Patients With 4 to 10 Brain Metastases Treated With Dose-Adapted Single-Isocenter Multitarget Stereotactic Radiosurgery: A Prospective Study. Adv Radiat Oncol. 2021;6(6):100760.
Journal cover image

Published In

Adv Radiat Oncol

DOI

ISSN

2452-1094

Publication Date

2021

Volume

6

Issue

6

Start / End Page

100760

Location

United States

Related Subject Headings

  • 3211 Oncology and carcinogenesis