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Feasibility of linac-based fractionated stereotactic radiotherapy and stereotactic radiosurgery for patients with up to ten brain metastases

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...

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Autores principales: Hirata, Masanori, Yasui, Kazuaki, Oota, Naofumi, Ogawa, Hirofumi, Onoe, Tsuyoshi, Maki, Sayo, Ito, Yusuke, Hayashi, Kenji, Asakura, Hirofumi, Murayama, Shigeyuki, Mitsuya, Koichi, Deguchi, Shoichi, Nakamura, Katsumasa, Hayashi, Nakamasa, Nishimura, Tetsuo, Harada, Hideyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9795627/
https://www.ncbi.nlm.nih.gov/pubmed/36578021
http://dx.doi.org/10.1186/s13014-022-02185-1
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author Hirata, Masanori
Yasui, Kazuaki
Oota, Naofumi
Ogawa, Hirofumi
Onoe, Tsuyoshi
Maki, Sayo
Ito, Yusuke
Hayashi, Kenji
Asakura, Hirofumi
Murayama, Shigeyuki
Mitsuya, Koichi
Deguchi, Shoichi
Nakamura, Katsumasa
Hayashi, Nakamasa
Nishimura, Tetsuo
Harada, Hideyuki
author_facet Hirata, Masanori
Yasui, Kazuaki
Oota, Naofumi
Ogawa, Hirofumi
Onoe, Tsuyoshi
Maki, Sayo
Ito, Yusuke
Hayashi, Kenji
Asakura, Hirofumi
Murayama, Shigeyuki
Mitsuya, Koichi
Deguchi, Shoichi
Nakamura, Katsumasa
Hayashi, Nakamasa
Nishimura, Tetsuo
Harada, Hideyuki
author_sort Hirata, Masanori
collection PubMed
description 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.
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spelling pubmed-97956272022-12-29 Feasibility of linac-based fractionated stereotactic radiotherapy and stereotactic radiosurgery for patients with up to ten brain metastases Hirata, Masanori Yasui, Kazuaki Oota, Naofumi Ogawa, Hirofumi Onoe, Tsuyoshi Maki, Sayo Ito, Yusuke Hayashi, Kenji Asakura, Hirofumi Murayama, Shigeyuki Mitsuya, Koichi Deguchi, Shoichi Nakamura, Katsumasa Hayashi, Nakamasa Nishimura, Tetsuo Harada, Hideyuki Radiat Oncol Research 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. BioMed Central 2022-12-28 /pmc/articles/PMC9795627/ /pubmed/36578021 http://dx.doi.org/10.1186/s13014-022-02185-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Hirata, Masanori
Yasui, Kazuaki
Oota, Naofumi
Ogawa, Hirofumi
Onoe, Tsuyoshi
Maki, Sayo
Ito, Yusuke
Hayashi, Kenji
Asakura, Hirofumi
Murayama, Shigeyuki
Mitsuya, Koichi
Deguchi, Shoichi
Nakamura, Katsumasa
Hayashi, Nakamasa
Nishimura, Tetsuo
Harada, Hideyuki
Feasibility of linac-based fractionated stereotactic radiotherapy and stereotactic radiosurgery for patients with up to ten brain metastases
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 Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9795627/
https://www.ncbi.nlm.nih.gov/pubmed/36578021
http://dx.doi.org/10.1186/s13014-022-02185-1
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