2024-03-28T11:35:11Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:00028455
2023-11-16T02:58:12Z
499:508:509:2431
Retrospective analysis of hypofractionated stereotactic radiotherapy for tumors larger than 2 cm
Koide, Yutaro
Tomita, Natsuo
Adachi, Sou
Tanaka, Hiroshi
Tachibana, Hiroyuki
Kodaira, Takeshi
open access
Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
helical tomotherapy
stereotactic radiotherapy
radiosurgery
brain metastases
radiation necrosis
Stereotactic radiosurgery for large brain metastases (BM) not amenable to surgical resection is associated with limited local control and neurotoxicity, while hypofractionated stereotactic radiotherapy (HFSRT) has emerged as a promising option. We retrospectively evaluated 61 patients with BM larger than 2 cm in the maximum diameter, who were treated with HFSRT (mainly 35 Gy/5 fractions) in our center between 2006–2016, focusing on the effect of BM size on outcomes. Eligible patients were divided according to the maximum BM diameter (group A [23 patients]: ≥3 cm, group B [22 patients]: <3 cm) to assess the relationship between tumor size and prognosis or safety. The primary outcome was the local control rate (LCR), and secondary outcomes were the response rate (RR), brain progression-free survival (BPFS), median survival time (MST), and radionecrosis (RN). Univariate and multivariate analyses for LCR were conducted using Cox’s proportional hazards model. In the 45 eligible patients (58 lesions) enrolled in this study, the RR was 86.4% with an overall LCR of 64.7% at 12 months (67.1% for group A and 61.5% for group B [p = 0.45]). The median BPFS and MST were 11.6 and 14.2 months, respectively. Univariate analyses revealed that female patients and gynecological cancer patients had poorer LCR, but they were not significantly independent prognostic factors (p = 0.06, 0.09, respectively). Two patients (4.4%) experienced RN that was detected more than 4 years after HFSRT. We conclude that HFSRT is safe for large BM but further studies are needed to determine optimal doses and fractions.
Nagoya University Graduate School of Medicine, School of Medicine
2019-08
eng
departmental bulletin paper
VoR
https://doi.org/10.18999/nagjms.81.3.397
http://hdl.handle.net/2237/00030646
https://nagoya.repo.nii.ac.jp/records/28455
10.18999/nagjms.81.3.397
http://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/813.html
2186-3326
0027-7622
Nagoya Journal of Medical Science
81
3
397
406
https://nagoya.repo.nii.ac.jp/record/28455/files/05_Koide.pdf
application/pdf
618.7 kB
2019-09-04