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Efficacy and Safety of a Second Course of Stereotactic Radiation Therapy for Locally Recurrent Brain Metastases: A Systematic Review

SIMPLE SUMMARY: Approximately 30% of patients diagnosed with cancer will ultimately develop brain metastases. Many improvements have been made in systemic and local cancer treatments, which have increased overall survival but also, as a consequence, the number of patients who present with local recu...

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Autores principales: Lucia, François, Touati, Ruben, Crainic, Nicolae, Dissaux, Gurvan, Pradier, Olivier, Bourbonne, Vincent, Schick, Ulrike
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8508410/
https://www.ncbi.nlm.nih.gov/pubmed/34638412
http://dx.doi.org/10.3390/cancers13194929
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author Lucia, François
Touati, Ruben
Crainic, Nicolae
Dissaux, Gurvan
Pradier, Olivier
Bourbonne, Vincent
Schick, Ulrike
author_facet Lucia, François
Touati, Ruben
Crainic, Nicolae
Dissaux, Gurvan
Pradier, Olivier
Bourbonne, Vincent
Schick, Ulrike
author_sort Lucia, François
collection PubMed
description SIMPLE SUMMARY: Approximately 30% of patients diagnosed with cancer will ultimately develop brain metastases. Many improvements have been made in systemic and local cancer treatments, which have increased overall survival but also, as a consequence, the number of patients who present with local recurrence following intracranial stereotactic radiotherapy. The management of these recurrences remains controversial. The aim of our review is to evaluate the efficacy and tolerance of a second course of stereotactic radiotherapy. ABSTRACT: Recent advances in cancer treatments have increased overall survival and consequently, local failures (LFs) after stereotactic radiotherapy/radiosurgery (SRS/SRT) have become more frequent. LF following SRS or SRT may be treated with a second course of SRS (SRS2) or SRT (SRT2). However, there is no consensus on whenever to consider reirradiation. A literature search was conducted according to PRISMA guidelines. Analysis included 13 studies: 329 patients (388 metastases) with a SRS2 and 135 patients (161 metastases) with a SRT2. The 1-year local control rate ranged from 46.5% to 88.3%. Factors leading to poorer LC were histology (melanoma) and lack of prior whole-brain radiation therapy, large tumor size and lower dose at SRS2/SRT2, poorer response at first SRS/SRT, poorer performance status, and no controlled extracranial disease. The rate of radionecrosis (RN) ranged from 2% to 36%. Patients who had a large tumor volume, higher dose and higher value of prescription isodose line at SRS2/SRT2, and large overlap between brain volume irradiated at SRS1/SRT1 and SRS2/SRT2 at doses of 18 and 12 Gy had a higher risk of developing RN. Prospective studies involving a larger number of patients are still needed to determine the best management of patients with local recurrence of brain metastases
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spelling pubmed-85084102021-10-13 Efficacy and Safety of a Second Course of Stereotactic Radiation Therapy for Locally Recurrent Brain Metastases: A Systematic Review Lucia, François Touati, Ruben Crainic, Nicolae Dissaux, Gurvan Pradier, Olivier Bourbonne, Vincent Schick, Ulrike Cancers (Basel) Systematic Review SIMPLE SUMMARY: Approximately 30% of patients diagnosed with cancer will ultimately develop brain metastases. Many improvements have been made in systemic and local cancer treatments, which have increased overall survival but also, as a consequence, the number of patients who present with local recurrence following intracranial stereotactic radiotherapy. The management of these recurrences remains controversial. The aim of our review is to evaluate the efficacy and tolerance of a second course of stereotactic radiotherapy. ABSTRACT: Recent advances in cancer treatments have increased overall survival and consequently, local failures (LFs) after stereotactic radiotherapy/radiosurgery (SRS/SRT) have become more frequent. LF following SRS or SRT may be treated with a second course of SRS (SRS2) or SRT (SRT2). However, there is no consensus on whenever to consider reirradiation. A literature search was conducted according to PRISMA guidelines. Analysis included 13 studies: 329 patients (388 metastases) with a SRS2 and 135 patients (161 metastases) with a SRT2. The 1-year local control rate ranged from 46.5% to 88.3%. Factors leading to poorer LC were histology (melanoma) and lack of prior whole-brain radiation therapy, large tumor size and lower dose at SRS2/SRT2, poorer response at first SRS/SRT, poorer performance status, and no controlled extracranial disease. The rate of radionecrosis (RN) ranged from 2% to 36%. Patients who had a large tumor volume, higher dose and higher value of prescription isodose line at SRS2/SRT2, and large overlap between brain volume irradiated at SRS1/SRT1 and SRS2/SRT2 at doses of 18 and 12 Gy had a higher risk of developing RN. Prospective studies involving a larger number of patients are still needed to determine the best management of patients with local recurrence of brain metastases MDPI 2021-09-30 /pmc/articles/PMC8508410/ /pubmed/34638412 http://dx.doi.org/10.3390/cancers13194929 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Lucia, François
Touati, Ruben
Crainic, Nicolae
Dissaux, Gurvan
Pradier, Olivier
Bourbonne, Vincent
Schick, Ulrike
Efficacy and Safety of a Second Course of Stereotactic Radiation Therapy for Locally Recurrent Brain Metastases: A Systematic Review
title Efficacy and Safety of a Second Course of Stereotactic Radiation Therapy for Locally Recurrent Brain Metastases: A Systematic Review
title_full Efficacy and Safety of a Second Course of Stereotactic Radiation Therapy for Locally Recurrent Brain Metastases: A Systematic Review
title_fullStr Efficacy and Safety of a Second Course of Stereotactic Radiation Therapy for Locally Recurrent Brain Metastases: A Systematic Review
title_full_unstemmed Efficacy and Safety of a Second Course of Stereotactic Radiation Therapy for Locally Recurrent Brain Metastases: A Systematic Review
title_short Efficacy and Safety of a Second Course of Stereotactic Radiation Therapy for Locally Recurrent Brain Metastases: A Systematic Review
title_sort efficacy and safety of a second course of stereotactic radiation therapy for locally recurrent brain metastases: a systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8508410/
https://www.ncbi.nlm.nih.gov/pubmed/34638412
http://dx.doi.org/10.3390/cancers13194929
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