Imaging changes over 18 months following stereotactic radiosurgery for brain metastases: both late radiation necrosis and tumor progression can occur

Journal of Neuro-oncology
Dylann FujimotoScott G Soltys

Abstract

Following stereotactic radiosurgery (SRS) for brain metastases, the median time range to develop adverse radiation effect (ARE) or radiation necrosis is 7-11 months. Similarly, the risk of local tumor recurrence following SRS is < 5% after 18 months. With improvements in systemic therapy, patients are living longer and are at risk for both late (defined as > 18 months after SRS) tumor recurrence and late ARE, which have not previously been well described. An IRB-approved, retrospective review identified patients treated with SRS who developed new MRI contrast enhancement > 18 months following SRS. ARE was defined as stabilization/shrinkage of the lesion over time or pathologic confirmation of necrosis, without tumor. Local failure (LF) was defined as continued enlargement of the lesion over time or pathologic confirmation of tumor. We identified 16 patients, with a median follow-up of 48.2 months and median overall survival of 73.0 months, who had 19 metastases with late imaging changes occurring a median of 32.9 months (range 18.5-63.2 months) after SRS. Following SRS, 12 lesions had late ARE at a median of 33.2 months and 7 lesions had late LF occurring a median of 23.6 months. As patients with cancer live longer and as SRS i...Continue Reading

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Citations

May 8, 2018·Journal of Magnetic Resonance Imaging : JMRI·Stefanie C ThustMarion Smits
Oct 18, 2018·Acta neurochirurgica·Kira SeigerScott G Soltys
Apr 26, 2019·Topics in Magnetic Resonance Imaging : TMRI·Murat Alp OztekUpendra Parvathaneni
Sep 21, 2018·Frontiers in Oncology·Gokoulakrichenane LoganadaneAntonin Levy
Oct 30, 2020·Journal of Applied Clinical Medical Physics·Hisashi NakanoHidefumi Aoyama
Sep 18, 2021·Current Opinion in Oncology·Lucia Nichelli, Stefano Casagranda
Oct 14, 2021·International Journal of Radiation Oncology, Biology, Physics·Roman O KowalchukJason P Sheehan

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