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Radiosurgery for multiple brain metastases using volumetric modulated arc therapy: a single institutional series
BACKGROUND: Patients with brain metastases (BM) live longer due to improved diagnosis and oncologic treatments. The association of volumetric modulated arc therapy (VMAT) and image-guided radiation therapy (IGRT) with brain radiosurgery (SRS) allows complex dose distributions and faster treatment de...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Via Medica
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9521688/ https://www.ncbi.nlm.nih.gov/pubmed/36196425 http://dx.doi.org/10.5603/RPOR.a2022.0058 |
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author | Asso, Rie Nadia Mancini, Anselmo Palhares, Daniel Moore Freitas Junior, Wellington Furtado Pimenta Palhares Neves Marta, Gustavo Nader da Silva, João Luis Fernandes Ramos, Bibiana Ferreira Gouvea Gadia, Rafael Hanna, Samir Abdallah |
author_facet | Asso, Rie Nadia Mancini, Anselmo Palhares, Daniel Moore Freitas Junior, Wellington Furtado Pimenta Palhares Neves Marta, Gustavo Nader da Silva, João Luis Fernandes Ramos, Bibiana Ferreira Gouvea Gadia, Rafael Hanna, Samir Abdallah |
author_sort | Asso, Rie Nadia |
collection | PubMed |
description | BACKGROUND: Patients with brain metastases (BM) live longer due to improved diagnosis and oncologic treatments. The association of volumetric modulated arc therapy (VMAT) and image-guided radiation therapy (IGRT) with brain radiosurgery (SRS) allows complex dose distributions and faster treatment delivery to multiple lesions. MATERIALS AND METHODS: This study is a retrospective analysis of SRS for brain metastasis using VMAT. The primary endpoints were local disease-free survival (LDFS) and overall survival (OS). The secondary outcomes were intracranial disease-free survival (IDFS) and meningeal disease-free survival (MDFS). RESULTS: The average number of treated lesions was 5.79 (range: 2–20) per treatment in a total of 113 patients. The mean prescribed dose was 18 Gy (range: 12–24 Gy). The median LDFS was 46 months. The LDFS in 6, 12, and 24 months was for 86%, 79%, and 63%, respectively. Moreover, brain progression occurred in 50 patients. The median overall survival was 47 months. The OS in 75%, 69%, and 61% patients was 6, 12, and 24 months, respectively. IDFS was 6 and 24 months in 35% and 14% patients, respectively. The mean MDFS was 62 months; it was 6 and 24 months for 87% and 83% of patients. Acute severe toxicity was relatively rare. During follow-up, the rates of radionecrosis and neurocognitive impairment were low (10%). CONCLUSION: The use of VMAT–SRS for multiple BM was feasible, effective, and associated with low treatment-related toxicity rates. Thus, treatment with VMAT is a safe technique to plan to achieve local control without toxicity. |
format | Online Article Text |
id | pubmed-9521688 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Via Medica |
record_format | MEDLINE/PubMed |
spelling | pubmed-95216882022-10-03 Radiosurgery for multiple brain metastases using volumetric modulated arc therapy: a single institutional series Asso, Rie Nadia Mancini, Anselmo Palhares, Daniel Moore Freitas Junior, Wellington Furtado Pimenta Palhares Neves Marta, Gustavo Nader da Silva, João Luis Fernandes Ramos, Bibiana Ferreira Gouvea Gadia, Rafael Hanna, Samir Abdallah Rep Pract Oncol Radiother Research Paper BACKGROUND: Patients with brain metastases (BM) live longer due to improved diagnosis and oncologic treatments. The association of volumetric modulated arc therapy (VMAT) and image-guided radiation therapy (IGRT) with brain radiosurgery (SRS) allows complex dose distributions and faster treatment delivery to multiple lesions. MATERIALS AND METHODS: This study is a retrospective analysis of SRS for brain metastasis using VMAT. The primary endpoints were local disease-free survival (LDFS) and overall survival (OS). The secondary outcomes were intracranial disease-free survival (IDFS) and meningeal disease-free survival (MDFS). RESULTS: The average number of treated lesions was 5.79 (range: 2–20) per treatment in a total of 113 patients. The mean prescribed dose was 18 Gy (range: 12–24 Gy). The median LDFS was 46 months. The LDFS in 6, 12, and 24 months was for 86%, 79%, and 63%, respectively. Moreover, brain progression occurred in 50 patients. The median overall survival was 47 months. The OS in 75%, 69%, and 61% patients was 6, 12, and 24 months, respectively. IDFS was 6 and 24 months in 35% and 14% patients, respectively. The mean MDFS was 62 months; it was 6 and 24 months for 87% and 83% of patients. Acute severe toxicity was relatively rare. During follow-up, the rates of radionecrosis and neurocognitive impairment were low (10%). CONCLUSION: The use of VMAT–SRS for multiple BM was feasible, effective, and associated with low treatment-related toxicity rates. Thus, treatment with VMAT is a safe technique to plan to achieve local control without toxicity. Via Medica 2022-09-19 /pmc/articles/PMC9521688/ /pubmed/36196425 http://dx.doi.org/10.5603/RPOR.a2022.0058 Text en © 2022 Greater Poland Cancer Centre https://creativecommons.org/licenses/by-nc-nd/4.0/This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially |
spellingShingle | Research Paper Asso, Rie Nadia Mancini, Anselmo Palhares, Daniel Moore Freitas Junior, Wellington Furtado Pimenta Palhares Neves Marta, Gustavo Nader da Silva, João Luis Fernandes Ramos, Bibiana Ferreira Gouvea Gadia, Rafael Hanna, Samir Abdallah Radiosurgery for multiple brain metastases using volumetric modulated arc therapy: a single institutional series |
title | Radiosurgery for multiple brain metastases using volumetric modulated arc therapy: a single institutional series |
title_full | Radiosurgery for multiple brain metastases using volumetric modulated arc therapy: a single institutional series |
title_fullStr | Radiosurgery for multiple brain metastases using volumetric modulated arc therapy: a single institutional series |
title_full_unstemmed | Radiosurgery for multiple brain metastases using volumetric modulated arc therapy: a single institutional series |
title_short | Radiosurgery for multiple brain metastases using volumetric modulated arc therapy: a single institutional series |
title_sort | radiosurgery for multiple brain metastases using volumetric modulated arc therapy: a single institutional series |
topic | Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9521688/ https://www.ncbi.nlm.nih.gov/pubmed/36196425 http://dx.doi.org/10.5603/RPOR.a2022.0058 |
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