Postoperative stereotactic radiosurgery and hypofractionated radiotherapy for brain metastases using Gamma Knife and CyberKnife: a dual-center analysis.

IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY
Journal of neurosurgical sciences Pub Date : 2024-02-01 Epub Date: 2020-02-04 DOI:10.23736/S0390-5616.20.04830-4
Jens Kübler, Michael Wester-Ebbinghaus, Frederik Wenz, Florian Stieler, Bastian Bathen, Sabine K Mai, Robert Wolff, Daniel Hänggi, Oliver Blanck, Frank A Giordano
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引用次数: 0

Abstract

Background: Postoperative stereotactic radiosurgery (SRS) and hypofractionated stereotactic radiotherapy (hFSRT) to tumor cavities is emerging as a new standard of care after resection of brain metastases. Both Gamma Knife (GK) and CyberKnife (CK) are modalities commonly used for stereotactic radiotherapy, but fractional schemes are not consistent. The objective of this study was to evaluate outcomes in patients receiving postoperative stereotactic radiotherapy of resected brain metastases (BM) using different fractionation schedules and modalities in two large centers.

Methods: Patients with newly diagnosed BM who underwent postoperative SRS or hFSRT with either GK or CK at two large cancer centers were retrospectively evaluated. We analyzed local control (LC), regional control (RC) and overall survival (OS).

Results: From April 14th to May 18th, 2020, 79 patients with 81 resection cavities were treated. Forty-seven patients (59.5%) received GK and 32 patients (40.5%) received CK treatment. Fifty-four cavities (66.7%) were treated with hFSRT and 27 (33.3%) with SRS. The most common hFSRT and SRS scheme was 3x10 Gy and 1x16 Gy, respectively. Median OS was 11.7 months with survival rates of 44.7% at 1 year and 18.5% at 2 years. LC was 83.3% after 1 year. Median time to regional progression was 12.0 months with RC rates of 61.1% at 6 months and 41.0% at 12 months. There was no difference in OS, LC or RC between GK and CK treatments or SRS and hFSRT.

Conclusions: Both SRS and hFSRT provide high local control rates in resected BM regardless of the applied modality.

使用伽玛刀和CyberKnife治疗脑转移瘤的术后立体定向放射手术和低分次放射治疗:双中心分析。
背景:术后立体定向放射手术(SRS)和肿瘤腔低分次立体定向放射治疗(hFSRT)正在成为脑转移瘤切除术后的一种新的治疗标准。伽玛刀(GK)和CyberKnife(CK)都是立体定向放射治疗的常用模式,但它们的分次方案并不一致。本研究的目的是评估两家大型中心采用不同的分割计划和模式对切除的脑转移瘤(BM)进行术后立体定向放射治疗的患者的疗效:我们对在两家大型癌症中心接受术后 SRS 或 hFSRT(GK 或 CK)的新诊断脑转移瘤患者进行了回顾性评估。我们分析了局部控制率(LC)、区域控制率(RC)和总生存率(OS):从 2020 年 4 月 14 日到 5 月 18 日,共治疗了 79 例患者,81 个切除腔。47名患者(59.5%)接受了GK治疗,32名患者(40.5%)接受了CK治疗。54个腔隙(66.7%)接受了hFSRT治疗,27个腔隙(33.3%)接受了SRS治疗。最常见的 hFSRT 和 SRS 方案分别为 3x10 Gy 和 1x16 Gy。中位生存期为11.7个月,1年生存率为44.7%,2年生存率为18.5%。1年后的生存率为83.3%。区域进展的中位时间为12.0个月,6个月和12个月的RC率分别为61.1%和41.0%。GK和CK治疗或SRS和hFSRT在OS、LC或RC方面没有差异:结论:无论采用哪种方式,SRS和hFSRT都能为切除的骨髓瘤提供较高的局部控制率。
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
Journal of neurosurgical sciences
Journal of neurosurgical sciences CLINICAL NEUROLOGY-SURGERY
CiteScore
3.00
自引率
5.30%
发文量
202
审稿时长
>12 weeks
期刊介绍: The Journal of Neurosurgical Sciences publishes scientific papers on neurosurgery and related subjects (electroencephalography, neurophysiology, neurochemistry, neuropathology, stereotaxy, neuroanatomy, neuroradiology, etc.). Manuscripts may be submitted in the form of ditorials, original articles, review articles, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work.
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