Local control of brain metastases after stereotactic radiosurgery: the impact of whole brain radiotherapy and treatment paradigm

被引：0

作者：

Hughes, Ryan T. ^{[1
]}

Black, Paul J. ^{[1
]}

Page, Brandi R. ^{[1
]}

Lucas, John T., Jr. ^{[1
]}

Qasem, Shadi A. ^{[2
]}

Watabe, Kounosuke ^{[3
]}

Ruiz, Jimmy ^{[4
]}

Laxton, Adrian W. ^{[5
]}

Tatter, Stephen B. ^{[5
]}

Debinski, Waldemar ^{[6
]}

Chan, Michael D. ^{[1
]}

机构：

[1] Wake Forest Baptist Med Ctr, Dept Radiat Oncol, Med Ctr Blvd, Winston Salem, NC 27157 USA

[2] Wake Forest Baptist Med Ctr, Dept Pathol, Winston Salem, NC 27157 USA

[3] Wake Forest Sch Med, Dept Canc Biol, Winston Salem, NC 27157 USA

[4] Wake Forest Baptist Med Ctr, Dept Internal Med Hematol Oncol, Winston Salem, NC 27157 USA

[5] Wake Forest Baptist Med Ctr, Dept Neurosurg, Winston Salem, NC 27157 USA

[6] Wake Forest Baptist Med Ctr, Brain Tumor Ctr Excellence, Winston Salem, NC 27157 USA

来源：

JOURNAL OF RADIOSURGERY AND SBRT | 2016年 / 4卷 / 02期

关键词：

brain metastasis; stereotactic radiosurgery; whole brain radiotherapy; local failure; treatment paradigm; salvage therapy;

D O I：

暂无

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Purpose: We investigate clinical, pathologic, and treatment paradigm-related factors affecting local control of brain metastases after stereotactic radiosurgery (SRS) with or without whole brain radiotherapy (WBRT). Methods and materials: Patients with brain metastases treated with SRS alone, before or after WBRT were considered to determine predictors of local failure (LF), time to failure and survival. Results: Among 137 patients, 411 brain metastases were analyzed. 23% of patients received SRS alone, 51% received WBRT prior to SRS, and 26% received SRS followed by WBRT. LF occurred in 125 metastases: 63% after SRS alone, 20% after WBRT then SRS, and 22% after SRS then WBRT. Median time to local failure was significantly less after SRS alone compared to WBRT then SRS (12.1 v. 22.7 months, p=0.003). Tumor volume was significantly associated with LF (HR: 5.2, p<0.001, 95% CI: 3.4-7.8). Conclusions: WBRT+SRS results in reduced LF. Local control was not significantly different after SRS as salvage therapy versus upfront SRS.

引用

页码：89 / 96

页数：8

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