Association of increasing gross tumor volume dose with tumor volume reduction and local control in fractionated stereotactic radiosurgery for unresected brain metastases.

IF 3.3 2区医学 Q2 ONCOLOGY

Radiation Oncology Pub Date : 2024-07-27 DOI:10.1186/s13014-024-02487-6

Naoyuki Kanayama, Toshiki Ikawa, Koji Takano, Hideyuki Arita, Masahiro Morimoto, Takero Hirata, Kazuhiko Ogawa, Teruki Teshima, Koji Konishi

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引用次数: 0

Abstract

Background: Fractionated stereotactic radiosurgery (fSRS) is an important treatment strategy for unresected brain metastases. We previously reported that a good volumetric response 6 months after fSRS can be the first step for local control. Few studies have reported the association between gross tumor volume (GTV) dose, volumetric response, and local control in patients treated with the same number of fractions. Therefore, in this study, we aimed to investigate the GTV dose and volumetric response 6 months after fSRS in five daily fractions and identify the predictive GTV dose for local failure (LF) for unresected brain metastasis.

Methods: This retrospective study included 115 patients with 241 unresected brain metastases treated using fSRS in five daily fractions at our hospital between January 2013 and April 2022. The median prescription dose was 35 Gy (range, 30-35 Gy) in five fractions. The median follow-up time after fSRS was 16 months (range, 7-66 months).

Results: GTV D80 > 42 Gy and GTV D98 > 39 Gy were prognostic factors for over 65% volume reduction (odds ratio, 3.68, p < 0.01; odds ratio, 4.68, p < 0.01, respectively). GTV D80 > 42 Gy was also a prognostic factor for LF (hazard ratio, 0.37; p = 0.01).

Conclusions: GTV D80 > 42 Gy in five fractions led to better volume reduction and local control. The goal of planning an inhomogeneous dose distribution for fSRS in brain metastases may be to increase the GTV D80 and GTV D98. Further studies on inhomogeneous dose distributions are required.

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在对未切除的脑转移瘤进行分次立体定向放射外科治疗时，增加肿瘤总体积剂量与肿瘤体积缩小和局部控制的关系。

背景：分次立体定向放射手术（fSRS）是一种治疗未切除脑转移瘤的重要策略。我们曾报道，分次立体定向放射手术后 6 个月的良好体积反应是局部控制的第一步。很少有研究报道在相同分次治疗的患者中，肿瘤总体积（GTV）剂量、体积反应和局部控制之间的关联。因此，在这项研究中，我们旨在调查每天分五次进行 fSRS 治疗 6 个月后的 GTV 剂量和体积反应，并确定预测未切除脑转移瘤局部失败（LF）的 GTV 剂量：这项回顾性研究纳入了2013年1月至2022年4月期间在我院接受fSRS每日5次分次治疗的115例241例未切除脑转移瘤患者。处方剂量中位数为 35 Gy（范围为 30-35 Gy），分 5 次进行。中位随访时间为16个月（7-66个月）：结果：GTV D80 > 42 Gy 和 GTV D98 > 39 Gy 是体积缩小超过 65% 的预后因素（几率比 3.68，p 42 Gy 也是 LF 的预后因素（危险比 0.37；p = 0.01）：结论：五次分割的 GTV D80 > 42 Gy 能更好地缩小体积和控制局部。对脑转移灶进行非均匀剂量分布计划的目标可能是增加 GTV D80 和 GTV D98。有关不均匀剂量分布的研究还需进一步开展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiation Oncology ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

6.50

自引率

2.80%

发文量

181

审稿时长

3-6 weeks

期刊介绍： Radiation Oncology encompasses all aspects of research that impacts on the treatment of cancer using radiation. It publishes findings in molecular and cellular radiation biology, radiation physics, radiation technology, and clinical oncology.

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