Long-Term Survival after Linac-Based Stereotactic Radiosurgery and Radiotherapy with a Micro-Multileaf Collimator for Brain Metastasis

Long-Term Survival after Linac-Based Stereotactic Radiosurgery and Radiotherapy with a Micro-Multileaf Collimator for Brain Metastasis

Background: this study aimed to evaluate the prognostic factors associated with long-term survival after linear accelerator (linac)-based stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT) with a micro-multileaf collimator for brain metastasis (BM). Methods: This singl...

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Bibliographic Details
Main Authors: Ryosuke Matsuda, Masatoshi Hasegawa, Tetsuro Tamamoto, Nobuyoshi Inooka, Mei Nikimoto, Tomoko Ochi, Toshiteru Miyasaka, Shigeto Hontsu, Kaori Yamaki, Sachiko Miura, Takayuki Morimoto, Takaaki Mitsui, Takanori Furuta, Shohei Yokoyama, Masashi Kotsugi, Shuichi Yamada, Ichiro Nakagawa, Young-Soo Park, Hiroyuki Nakase
Format: Article
Language:English
Published: MDPI AG 2022-08-01
Series:Current Oncology
Subjects:
linac with a micro-multileaf collimator
brain metastasis
long-term survivors
stereotactic radiosurgery
stereotactic radiotherapy
Online Access:https://www.mdpi.com/1718-7729/29/9/477
Description
Summary:Background: this study aimed to evaluate the prognostic factors associated with long-term survival after linear accelerator (linac)-based stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT) with a micro-multileaf collimator for brain metastasis (BM). Methods: This single-center retrospective study included 226 consecutive patients with BM who were treated with linac-based SRS or fSRT with a micro-multileaf collimator between January 2011 and December 2018. Long-term survival (LTS) was defined as survival for more than 2 years after SRS/fSRT. Results: The tumors originated from the lung (<i>n</i> = 189, 83.6%), breast (<i>n</i> = 11, 4.9%), colon (<i>n</i> = 9, 4.0%), stomach (<i>n</i> = 4, 1.8%), kidney (<i>n</i> = 3, 1.3%), esophagus (<i>n</i> = 3, 1.3%), and other regions (<i>n</i> = 7, 3.1%). The median pretreatment Karnofsky performance scale (KPS) score was 90 (range: 40–100). The median follow-up time was 13 (range: 0–120) months. Out of the 226 patients, 72 (31.8%) were categorized in the LTS group. The median survival time was 43 months and 13 months in the LTS group and in the entire cohort, respectively. The 3-year, 4-year, and 5-year survival rate in the LTS group was 59.1%, 49.6%, and 40.7%, respectively. Multivariate regression logistic analysis showed that female sex, a pre-treatment KPS score ≥ 80, and the absence of extracranial metastasis were associated with long-term survival. Conclusions: female sex, a favorable pre-treatment KPS score, and the absence of extracranial metastasis were associated with long-term survival in the current cohort of patients with BM.
ISSN:1198-0052
1718-7729

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