Bibliographic Details
| Title: |
LINAC-based stereotactic radiosurgery with co-planar beams in the treatment of brain metastases. |
| Authors: |
Bianchi, Sofia Paola, Torrisi, Miriam, Trivellato, Sara, Lucchini, Raffaella, Purrello, Giorgio, Caricato, Paolo, Faccenda, Valeria, Daniotti, Martina Camilla, Panizza, Denis, Arcangeli, Stefano |
| Source: |
Journal of Radiosurgery & SBRT; 2022 Supplement, Vol. 8, p89-89, 1/2p |
| Subject Terms: |
STEREOTACTIC radiosurgery, BRAIN metastasis, DISEASE progression, TERMINALLY ill, RADIOSURGERY |
| Abstract: |
Aim: Single-fraction radiosurgery (SRS) and fractionated stereotactic radiosurgery (fSRS) are established treatment options in the management of brain metastases (BM). Limited data are available using a LINAC-based approach with co-planar arcs. This study analyzed a mono-institutional series of patients treated with this technique. Methods: From October 2019 to December 2021, 54 patients (102 BM) with different primary solid tumors were treated with SRS or fSRS delivered with single-isocenter coplanar FFF-VMAT on a Linac platform. Patients’ characteristics are summarized in Table 1. Post-treatment MRI scans were used to assess local control (LC) and disease progression (PD) according to the Response Evaluation Criteria in Solid Tumors (RECIST) scale. Survival curves were calculated from the date of treatment by using the Kaplan-Meier (KM) method. Results: Median age at diagnosis of BM was 67 years (34-85). Median follow up was 5.0 months (0.3-22.9). At the time of treatment, the median Graded Prognostic Assessment (GPA) score was 2.0 (0.5-3.5). The majority of patients (45 [83.3%]) had extracranial metastases, of whom 28 (51.9%) had visceral metastases. 83.9% and 16.1% of lesions received SRS (18-21 Gy in 1 fraction) and fSRS (27 Gy in 3 fractions), respectively. The mean GTV was 0.85 (0.08-4.97) cm3 and the mean PTV was 2.58 (0.67-11.96) cm3. Dosimetry statistics are reported in Table 1. LC and PD were observed in 19 (33.9%) and 21 (37.5%) treatments, respectively. The pattern of PD was extra-field in 12 patients (57%), in-field in 5 patients (24%) and both in- and extra-field in 4 patients (19.0%). Seven patients and 4 patients with extra-field PD were treated with whole brain radiotherapy (WBRT) or additional SRS, respectively. At the last follow-up 22 patients died and 6 patients were lost. Median OS and PFS were 7.6 months and 3.1 months, respectively. Conclusions: Our findings show that Linac-based SRS and fSRS with co-planar beams and a single isocenter is an effective treatment modality in the management of single or multiple BM. The analysis of a larger sample size and a longer clinical follow-up are needed to confirm these preliminary results. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
