Feasibility of linac-based fractionated stereotactic radiotherapy and stereotactic radiosurgery for patients with up to ten brain metastases
Abstract Background Linac-based fractionated stereotactic radiotherapy (fSRT) and stereotactic radiosurgery (SRS) are increasingly being used to manage patients with multiple metastases. This retrospective cohort study aimed to compare the outcomes after linac-based fSRT and SRS between three patien...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-12-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13014-022-02185-1 |
| _version_ | 1797863984351674368 |
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| author | Masanori Hirata Kazuaki Yasui Naofumi Oota Hirofumi Ogawa Tsuyoshi Onoe Sayo Maki Yusuke Ito Kenji Hayashi Hirofumi Asakura Shigeyuki Murayama Koichi Mitsuya Shoichi Deguchi Katsumasa Nakamura Nakamasa Hayashi Tetsuo Nishimura Hideyuki Harada |
| author_facet | Masanori Hirata Kazuaki Yasui Naofumi Oota Hirofumi Ogawa Tsuyoshi Onoe Sayo Maki Yusuke Ito Kenji Hayashi Hirofumi Asakura Shigeyuki Murayama Koichi Mitsuya Shoichi Deguchi Katsumasa Nakamura Nakamasa Hayashi Tetsuo Nishimura Hideyuki Harada |
| author_sort | Masanori Hirata |
| collection | DOAJ |
| description | Abstract Background Linac-based fractionated stereotactic radiotherapy (fSRT) and stereotactic radiosurgery (SRS) are increasingly being used to manage patients with multiple metastases. This retrospective cohort study aimed to compare the outcomes after linac-based fSRT and SRS between three patient groups classified based on the number of brain metastases (BMs): 1 BM, 2–4 BM, 5–10 BM. Methods The data of consecutive patients with 1–10 BMs treated with fSRT or SRS between July 2016 and June 2018 at a single institution were collected. Patients with previous whole-brain radiotherapy (WBRT), concurrent use of WBRT, or surgical resection were excluded from the analysis. A total of 176 patients were classified into three groups according to the number of BMs: 78, 67, and 31 patients in 1 BM, 2–4 BM, and 5–10 BM, respectively. The Kaplan–Meier method was used to estimate overall survival (OS) curves, and the cumulative incidence with competing risks was used to estimate local control (LC), distant intracranial failure (DIF), and radiation necrosis (RN). Results Median OS was 19.8 months (95% confidence interval [CI] 10.2–27.5), 7.3 months (4.9–11.1), and 5.1 months (4.0–9.0) in 1 BM, 2–4 BM, and 5–10 BM, respectively. Compared to 2–4 BM, 1 BM had significantly better OS (hazard ratio [HR] 0.59, 95% CI 0.40–0.87; p = 0.0075); however, 5–10 BM had comparable OS (HR 1.36, 95% CI 0.85–2.19; p = 0.199). There was no significant difference in LC, DIF, and RN between tumor number groups, but DIF was lower in 1 BM. RN of grade 2 or higher occurred in 21 patients (13.5%); grade 4 and 5 RN were not observed. Conclusions The linac-based fSRT and SRS for patients with 5–10 BMs is comparable to that for patients with 2–4 BMs in OS, LC, DIF, and RN. It seems reasonable to use linac-based fSRT and SRS in patients with 5–10 BMs. |
| first_indexed | 2024-04-09T22:44:16Z |
| format | Article |
| id | doaj.art-dddb9274f3db43f6bb3e8d5a95125c35 |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-04-09T22:44:16Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-dddb9274f3db43f6bb3e8d5a95125c352023-03-22T11:58:25ZengBMCRadiation Oncology1748-717X2022-12-0117111010.1186/s13014-022-02185-1Feasibility of linac-based fractionated stereotactic radiotherapy and stereotactic radiosurgery for patients with up to ten brain metastasesMasanori Hirata0Kazuaki Yasui1Naofumi Oota2Hirofumi Ogawa3Tsuyoshi Onoe4Sayo Maki5Yusuke Ito6Kenji Hayashi7Hirofumi Asakura8Shigeyuki Murayama9Koichi Mitsuya10Shoichi Deguchi11Katsumasa Nakamura12Nakamasa Hayashi13Tetsuo Nishimura14Hideyuki Harada15Radiation and Proton Therapy Center, Shizuoka Cancer CenterRadiation and Proton Therapy Center, Shizuoka Cancer CenterRadiation and Proton Therapy Center, Shizuoka Cancer CenterRadiation and Proton Therapy Center, Shizuoka Cancer CenterRadiation and Proton Therapy Center, Shizuoka Cancer CenterRadiation and Proton Therapy Center, Shizuoka Cancer CenterRadiation and Proton Therapy Center, Shizuoka Cancer CenterRadiation and Proton Therapy Center, Shizuoka Cancer CenterRadiation and Proton Therapy Center, Shizuoka Cancer CenterRadiation and Proton Therapy Center, Shizuoka Cancer CenterDivision of Neurosurgery, Shizuoka Cancer CenterDivision of Neurosurgery, Shizuoka Cancer CenterDepartment of Radiation Oncology, Hamamatsu University HospitalDivision of Neurosurgery, Shizuoka Cancer CenterRadiation and Proton Therapy Center, Shizuoka Cancer CenterRadiation and Proton Therapy Center, Shizuoka Cancer CenterAbstract Background Linac-based fractionated stereotactic radiotherapy (fSRT) and stereotactic radiosurgery (SRS) are increasingly being used to manage patients with multiple metastases. This retrospective cohort study aimed to compare the outcomes after linac-based fSRT and SRS between three patient groups classified based on the number of brain metastases (BMs): 1 BM, 2–4 BM, 5–10 BM. Methods The data of consecutive patients with 1–10 BMs treated with fSRT or SRS between July 2016 and June 2018 at a single institution were collected. Patients with previous whole-brain radiotherapy (WBRT), concurrent use of WBRT, or surgical resection were excluded from the analysis. A total of 176 patients were classified into three groups according to the number of BMs: 78, 67, and 31 patients in 1 BM, 2–4 BM, and 5–10 BM, respectively. The Kaplan–Meier method was used to estimate overall survival (OS) curves, and the cumulative incidence with competing risks was used to estimate local control (LC), distant intracranial failure (DIF), and radiation necrosis (RN). Results Median OS was 19.8 months (95% confidence interval [CI] 10.2–27.5), 7.3 months (4.9–11.1), and 5.1 months (4.0–9.0) in 1 BM, 2–4 BM, and 5–10 BM, respectively. Compared to 2–4 BM, 1 BM had significantly better OS (hazard ratio [HR] 0.59, 95% CI 0.40–0.87; p = 0.0075); however, 5–10 BM had comparable OS (HR 1.36, 95% CI 0.85–2.19; p = 0.199). There was no significant difference in LC, DIF, and RN between tumor number groups, but DIF was lower in 1 BM. RN of grade 2 or higher occurred in 21 patients (13.5%); grade 4 and 5 RN were not observed. Conclusions The linac-based fSRT and SRS for patients with 5–10 BMs is comparable to that for patients with 2–4 BMs in OS, LC, DIF, and RN. It seems reasonable to use linac-based fSRT and SRS in patients with 5–10 BMs.https://doi.org/10.1186/s13014-022-02185-1Brain metastasesLinac-based fractionated stereotactic radiotherapyLinac-based stereotactic radiosurgeryOverall survivalLocal controlRadiation necrosis |
| spellingShingle | Masanori Hirata Kazuaki Yasui Naofumi Oota Hirofumi Ogawa Tsuyoshi Onoe Sayo Maki Yusuke Ito Kenji Hayashi Hirofumi Asakura Shigeyuki Murayama Koichi Mitsuya Shoichi Deguchi Katsumasa Nakamura Nakamasa Hayashi Tetsuo Nishimura Hideyuki Harada Feasibility of linac-based fractionated stereotactic radiotherapy and stereotactic radiosurgery for patients with up to ten brain metastases Radiation Oncology Brain metastases Linac-based fractionated stereotactic radiotherapy Linac-based stereotactic radiosurgery Overall survival Local control Radiation necrosis |
| title | Feasibility of linac-based fractionated stereotactic radiotherapy and stereotactic radiosurgery for patients with up to ten brain metastases |
| title_full | Feasibility of linac-based fractionated stereotactic radiotherapy and stereotactic radiosurgery for patients with up to ten brain metastases |
| title_fullStr | Feasibility of linac-based fractionated stereotactic radiotherapy and stereotactic radiosurgery for patients with up to ten brain metastases |
| title_full_unstemmed | Feasibility of linac-based fractionated stereotactic radiotherapy and stereotactic radiosurgery for patients with up to ten brain metastases |
| title_short | Feasibility of linac-based fractionated stereotactic radiotherapy and stereotactic radiosurgery for patients with up to ten brain metastases |
| title_sort | feasibility of linac based fractionated stereotactic radiotherapy and stereotactic radiosurgery for patients with up to ten brain metastases |
| topic | Brain metastases Linac-based fractionated stereotactic radiotherapy Linac-based stereotactic radiosurgery Overall survival Local control Radiation necrosis |
| url | https://doi.org/10.1186/s13014-022-02185-1 |
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