Simultaneous stereotactic radiosurgery of multiple brain metastases using single-isocenter dynamic conformal arc therapy: a prospective monocentric registry trial.
Elements Multiple Brain Mets®
Linear accelerator
Local ablative therapy
Oligometastases
Radiotherapy
Journal
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]
ISSN: 1439-099X
Titre abrégé: Strahlenther Onkol
Pays: Germany
ID NLM: 8603469
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
22
10
2020
accepted:
23
03
2021
pubmed:
23
4
2021
medline:
2
9
2021
entrez:
22
4
2021
Statut:
ppublish
Résumé
Single-isocenter dynamic conformal arc (SIDCA) therapy is a technically efficient way of delivering stereotactic radiosurgery (SRS) to multiple metastases simultaneously. This study reports on the safety and feasibility of linear accelerator (LINAC) based SRS with SIDCA for patients with multiple brain metastases. All patients who received SRS with this technique between November 2017 and June 2019 within a prospective registry trial were included. The patients were irradiated with a dedicated planning tool for multiple brain metastases using a LINAC with a 5 mm multileaf collimator. Follow-up was performed every 3 months, including clinical and radiological examination with cranial magnetic resonance imaging (MRI). These early data were analyzed using descriptive statistics and the Kaplan-Meier method. A total of 65 patients with 254 lesions (range 2-12) were included in this analysis. Median beam-on time was 23 min. The median follow-up at the time of analysis was 13 months (95% CI 11.1-14.9). Median overall survival and median intracranial progression-free survival was 15 months (95% CI 7.7-22.3) and 7 months (95% CI 3.9-10.0), respectively. Intracranial and local control after 1 year was 64.6 and 97.5%, respectively. During follow-up, CTCAE grade I adverse effects (AE) were experienced by 29 patients (44.6%; 18 of them therapy related, 27.7%), CTCAE grade II AEs by four patients (6.2%; one of them therapy related, 1.5%), and CTCAE grade III by three patients (4.6%; none of them therapy related). Two lesions (0.8%) in two patients (3.1%) were histopathologically proven to be radiation necrosis. Simultaneous SRS using SIDCA seems to be a feasible and safe treatment for patients with multiple brain metastases.
Sections du résumé
BACKGROUND
Single-isocenter dynamic conformal arc (SIDCA) therapy is a technically efficient way of delivering stereotactic radiosurgery (SRS) to multiple metastases simultaneously. This study reports on the safety and feasibility of linear accelerator (LINAC) based SRS with SIDCA for patients with multiple brain metastases.
METHODS
All patients who received SRS with this technique between November 2017 and June 2019 within a prospective registry trial were included. The patients were irradiated with a dedicated planning tool for multiple brain metastases using a LINAC with a 5 mm multileaf collimator. Follow-up was performed every 3 months, including clinical and radiological examination with cranial magnetic resonance imaging (MRI). These early data were analyzed using descriptive statistics and the Kaplan-Meier method.
RESULTS
A total of 65 patients with 254 lesions (range 2-12) were included in this analysis. Median beam-on time was 23 min. The median follow-up at the time of analysis was 13 months (95% CI 11.1-14.9). Median overall survival and median intracranial progression-free survival was 15 months (95% CI 7.7-22.3) and 7 months (95% CI 3.9-10.0), respectively. Intracranial and local control after 1 year was 64.6 and 97.5%, respectively. During follow-up, CTCAE grade I adverse effects (AE) were experienced by 29 patients (44.6%; 18 of them therapy related, 27.7%), CTCAE grade II AEs by four patients (6.2%; one of them therapy related, 1.5%), and CTCAE grade III by three patients (4.6%; none of them therapy related). Two lesions (0.8%) in two patients (3.1%) were histopathologically proven to be radiation necrosis.
CONCLUSION
Simultaneous SRS using SIDCA seems to be a feasible and safe treatment for patients with multiple brain metastases.
Identifiants
pubmed: 33884441
doi: 10.1007/s00066-021-01773-6
pii: 10.1007/s00066-021-01773-6
pmc: PMC8219560
doi:
Types de publication
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
601-613Références
Radiat Oncol. 2019 Mar 15;14(1):46
pubmed: 30876444
J Appl Clin Med Phys. 2016 Jan 08;17(1):92-101
pubmed: 26894335
Med Dosim. 2012 Autumn;37(3):257-64
pubmed: 22365418
J Clin Oncol. 2020 Apr 1;38(10):1019-1029
pubmed: 32058845
J Clin Oncol. 2013 Jan 1;31(1):65-72
pubmed: 23213105
Int J Radiat Oncol Biol Phys. 2007 Oct 1;69(2):589-97
pubmed: 17869672
Radiat Oncol. 2014 Jun 16;9:139
pubmed: 24935286
Strahlenther Onkol. 2020 Jan;196(1):70-76
pubmed: 31586230
Int J Radiat Oncol Biol Phys. 2010 Oct 1;78(2):605-8
pubmed: 20472351
J Radiosurg SBRT. 2016;4(1):5-6
pubmed: 29296420
Int J Radiat Oncol Biol Phys. 2011 Apr 1;79(5):1487-95
pubmed: 20399573
Lancet Oncol. 2009 Nov;10(11):1037-44
pubmed: 19801201
Clin Exp Metastasis. 2020 Feb;37(1):77-83
pubmed: 31691873
Strahlenther Onkol. 2015 Jun;191(6):461-9
pubmed: 25592907
Radiat Oncol. 2014 May 02;9:105
pubmed: 24885624
J Clin Oncol. 2006 Mar 10;24(8):1295-304
pubmed: 16525185
J Immunother Cancer. 2019 Apr 11;7(1):102
pubmed: 30975225
Front Oncol. 2019 Aug 07;9:703
pubmed: 31440464
Neuro Oncol. 2019 May 6;21(5):585-595
pubmed: 30615138
Neuro Oncol. 2017 Feb 1;19(2):162-174
pubmed: 28391295
Neuro Oncol. 2013 Oct;15(10):1429-37
pubmed: 23956241
Radiat Oncol. 2016 Dec 7;11(1):158
pubmed: 27927235
J Clin Oncol. 2014 Dec 1;32(34):3810-6
pubmed: 25349290
Neurooncol Pract. 2019 Sep;6(5):402-409
pubmed: 31555455
Stereotact Funct Neurosurg. 2017;95(4):268-278
pubmed: 28810243
Adv Radiat Oncol. 2019 Sep 16;5(1):70-76
pubmed: 32051892
Int J Radiat Oncol Biol Phys. 2017 Sep 1;99(1):31-40
pubmed: 28816158
J Neurosurg. 2014 Dec;121 Suppl:16-25
pubmed: 25434933
Surg Neurol Int. 2013 May 02;4(Suppl 4):S192-202
pubmed: 23717790
Radiat Oncol. 2018 Mar 5;13(1):38
pubmed: 29506539
Lancet Oncol. 2014 Apr;15(4):387-95
pubmed: 24621620
Strahlenther Onkol. 2014 Jun;190(6):521-32
pubmed: 24715242
Strahlenther Onkol. 2014 Apr;190(4):337-41
pubmed: 24452816
Lancet Oncol. 2017 Aug;18(8):1040-1048
pubmed: 28687375
Technol Cancer Res Treat. 2019 Jan 1;18:1533033819871621
pubmed: 31451059
J Cancer Res Clin Oncol. 2019 Jan;145(1):193-200
pubmed: 30382369
Prog Neurol Surg. 2019;34:110-124
pubmed: 31096244
Adv Radiat Oncol. 2017 Sep 11;2(4):555-563
pubmed: 29204522
N Engl J Med. 2017 Oct 5;377(14):1345-1356
pubmed: 28889792
J Clin Oncol. 2011 Jan 10;29(2):134-41
pubmed: 21041710
Lancet. 2016 Oct 22;388(10055):2004-2014
pubmed: 27604504
Lancet Oncol. 2017 Aug;18(8):1049-1060
pubmed: 28687377
Neuro Oncol. 2020 Dec 18;22(12):1831-1839
pubmed: 32347302
Int J Radiat Oncol Biol Phys. 2010 Jan 1;76(1):296-302
pubmed: 19836151
Lancet Oncol. 2016 Jul;17(7):976-983
pubmed: 27267608
Int J Radiat Oncol Biol Phys. 2019 Mar 1;103(3):618-630
pubmed: 30395902
Radiat Oncol. 2019 Jun 11;14(1):103
pubmed: 31186023