Stereotactic Radiotherapy and Resection of Brain Metastases

Yeboa, Debra Nana; Gibbs, Iris C.

doi:10.1001/jamaoncol.2020.4400

Cited by 2 publications

(2 citation statements)

References 7 publications

(11 reference statements)

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“…Prospective, high-quality data on the safety of stereotactic treatments with such treatments remain scarce but are crucial to advance the field and ensure patient safety. 30 This study possesses several limitations primarily stemming from its retrospective design and inherent sampling biases. The treatment decision for stereotactic irradiation of the BSM in favor of WBRT, the radiation dose, and the number of fractions were not standardized between the centers.…”

Section: Discussionmentioning

confidence: 99%

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Stereotactic radiosurgery and radiotherapy for brainstem metastases: An international multicenter analysis

Ehret,

Rueß,

Blanck

et al. 2024

Intl Journal of Cancer

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Brainstem metastases (BSM) present a significant neuro‐oncological challenge, resulting in profound neurological deficits and poor survival outcomes. Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) offer promising therapeutic avenues for BSM despite their precarious location. This international multicenter study investigates the efficacy and safety of SRS and FSRT in 136 patients with 144 BSM treated at nine institutions from 2005 to 2022. The median radiographic and clinical follow‐up periods were 6.8 and 9.4 months, respectively. Predominantly, patients with BSM were managed with SRS (69.4%). The median prescription dose and isodose line for SRS were 18 Gy and 65%, respectively, while for FSRT, the median prescription dose was 21 Gy with a median isodose line of 70%. The 12‐, 24‐, and 36‐month local control (LC) rates were 82.9%, 71.4%, and 61.2%, respectively. Corresponding overall survival rates at these time points were 61.1%, 34.7%, and 19.3%. In the multivariable Cox regression analysis for LC, only the minimum biologically effective dose was significantly associated with LC, favoring higher doses for improved control (in Gy, hazard ratio [HR]: 0.86, p < .01). Regarding overall survival, good performance status (Karnofsky performance status, ≥90%; HR: 0.43, p < .01) and prior whole brain radiotherapy (HR: 2.52, p < .01) emerged as associated factors. In 14 BSM (9.7%), treatment‐related adverse events were noted, with a total of five (3.4%) radiation necrosis. SRS and FSRT for BSM exhibit efficacy and safety, making them suitable treatment options for affected patients.

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Section: Discussionmentioning

confidence: 99%

“…Potential concerns and risks of increased treatment‐associated toxicity persist. Prospective, high‐quality data on the safety of stereotactic treatments with such treatments remain scarce but are crucial to advance the field and ensure patient safety 30 …”

Section: Discussionmentioning

confidence: 99%