Hypofractionated Stereotactic Radiosurgery in the Management of Brain Metastases

被引:2
作者
Lehrer, Eric J. [1 ]
Breen, William G. [1 ]
Singh, Raj [2 ]
Palmer, Joshua D. [2 ]
Brown, Paul D. [1 ]
Trifiletti, Daniel M. [3 ]
Sheehan, Jason P. [4 ]
机构
[1] Mayo Clin, Dept Radiat Oncol, 200 1st St SW, Rochester, MN 55905 USA
[2] Ohio State Univ, Wexner Med Ctr, Dept Radiat Oncol, Columbus, OH USA
[3] Mayo Clin, Dept Radiat Oncol, Jacksonville, FL USA
[4] Univ Virginia, Dept Neurol Surg, Charlottesville, VA USA
基金
美国国家卫生研究院;
关键词
Brain metastases; Neurosurgery; Radiation oncology; Stereotactic radiosurgery; Hypofractionation; SINGLE METASTASES; RADIOTHERAPY; RISK; N107C/CEC.3; AVOIDANCE; MEMANTINE; THERAPY; TRIAL;
D O I
10.1227/neu.0000000000002897
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Stereotactic radiosurgery (SRS) is an important weapon in the management of brain metastases. Single-fraction SRS is associated with local control rates ranging from approximately 70% to 100%, which are largely dependent on lesion and postoperative cavity size. The rates of local control and improved neurocognitive outcomes compared with conventional whole-brain radiation therapy have led to increased adoption of SRS in these settings. However, when treating larger targets and/or targets located in eloquent locations, the risk of normal tissue toxicity and adverse radiation effects within healthy brain tissue becomes significantly higher. Thus, hypofractionated SRS has become a widely adopted approach, which allows for the delivery of ablative doses of radiation while also minimizing the risk of toxicity. This approach has been studied in multiple retrospective reports in both the postoperative and intact settings. While there are no reported randomized data to date, there are trials underway evaluating this paradigm. In this article, we review the role of hypofractionated SRS in the management of brain metastases and emerging data that will serve to validate this treatment approach. Pertinent articles and references were obtained from a comprehensive search of PubMed/MEDLINE and clinicaltrials.gov.
引用
收藏
页码:253 / 258
页数:6
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