Fractionated stereotactic radiotherapy using CyberKnife for the treatment of large brain metastases: a dose escalation study

Clinical Oncology : a Journal of the Royal College of Radiologists
T MuraiY Shibamoto

Abstract

To evaluate the toxicity and efficacy of fractionated stereotactic radiotherapy (FSRT) with doses of 18-30 Gy in three fractions and 21-35 Gy in five fractions against large brain metastases. Between 2005 and 2012, 61 large brain metastases (≥ 2.5 cm in maximum diameter) of a total of 102 in 54 patients were treated with FSRT as a first-line therapy. Neurological symptoms were observed in 47 of the 54 patients before FSRT. Three fractions were applied to tumours with a maximum diameter ≥ 2.5 cm and <4 cm, and five fractions were used for brain metastases ≥ 4 cm. After ensuring that the toxicities were acceptable (≤ grade 2), doses were escalated in steps. Doses to the large brain metastases were as follows: level I, 18-22 Gy/three fractions or 21-25 Gy/five fractions; level II, 22-27 Gy/three fractions or 25-31 Gy/five fractions; level III, 27-30 Gy/three fractions or 31-35 Gy/five fractions. Level III was the target dose level. Overall survival rates were 52 and 31% at 6 and 12 months, respectively. Local tumour control rates of the 102 total brain metastases were 84 and 78% at 6 and 12 months, respectively. Local tumour control rates of the 61 large brain metastases were 77 and 69% at 6 and 12 months, respectively. Grade 3 or...Continue Reading

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Citations

Feb 11, 2015·Clinical Oncology : a Journal of the Royal College of Radiologists·M B PinkhamM Brada
Sep 25, 2017·Journal of Neurosurgery·Lilyana AngelovGene H Barnett
Nov 7, 2018·Journal of Korean Neurosurgical Society·Kyoung Jun YoonYoung Hyun Cho
Nov 6, 2015·Journal of Korean Neurosurgical Society·Won Joo JeongYoung Hyun Cho
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Jul 12, 2018·Journal of Korean Neurosurgical Society·Tae Kyoo LimGi Taek Yee
Jan 4, 2021·Clinical & Experimental Metastasis·Yavuz SamanciSelcuk Peker
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Feb 28, 2021·Journal of Cancer Research and Clinical Oncology·Sergej TelentschakMaximilian Ruge
Jan 5, 2021·International Journal of Radiation Oncology, Biology, Physics·Kristin J RedmondLawrence R Kleinberg

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