Repeat stereotactic radiosurgery for recurrent brain metastases: a retrospective comparison of local progression and distant brain metastases after prior radiosurgery

被引:0
作者
Noguchi, Masamune [1 ,2 ]
Koide, Yutaro [1 ]
Shindo, Yurika [1 ,2 ]
Aoyama, Takahiro [1 ]
Hashimoto, Shingo [1 ]
Tachibana, Hiroyuki [1 ]
Kodaira, Takeshi [1 ]
Ishihara, Shunichi [2 ]
Naganawa, Shinji [2 ]
机构
[1] Aichi Canc Ctr Hosp, Dept Radiat Oncol, Kanokoden 1-1,Chikusa Ku, Nagoya, Aichi, Japan
[2] Nagoya Univ, Grad Sch Med, Dept Radiol, Nagoya, Japan
基金
日本学术振兴会;
关键词
Brain metastases; Stereotactic radiosurgery; Radiation necrosis; Repeat radiosurgery; Reirradiation; RADIATION NECROSIS; SALVAGE THERAPY; RADIOTHERAPY; MANAGEMENT; DISEASE;
D O I
10.1007/s11060-025-05035-8
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Aim This study evaluated the efficacy and safety of repeat stereotactic radiosurgery (SRS) for recurrent brain metastases (BMs), focusing on failure patterns of local progression (LP) and distant brain metastases (DBM). Methods Patients who underwent first-time SRS for newly diagnosed BMs (2011-2022) and repeat SRS (until June 2024) were included. Treatment courses were first-time or repeat SRS, with repeat SRS classified as LP and DBM. The primary endpoint was the 1-year local control rate (LCR). Secondary endpoints included survival and radiation necrosis (RN) incidence. Results Among 723 courses (427 patients, 4,524 BMs), 404 (141 patients, 2,924 BMs) met criteria. First-time SRS was performed in 141 courses (775 BMs), and repeat SRS in 263 (2,149 BMs), including 45 LP (38 patients, 224 BMs) and 218 DBM (126 patients, 1,925 BMs). The median age was 65 years, and 75.9% had lung cancer. LP had a longer interval from prior SRS (12.6 vs. 6.3 months, P < 0.001) but similar follow-up (12.4 vs. 13.7 months). The 1-year LCR was lower in LP (72.4% vs. 88.3%, P = 0.0022), though survival was similar (17.9 vs. 16.3 months). LP had higher RN incidence (20.6% vs. 5.7%, P < 0.001) and symptomatic RN (13.3% vs. 2.8%, P < 0.001). Multivariate analysis identified LP failure as a significant factor for increased local failure (subdistribution hazard ratio [SHR] 2.35, P = 0.039) and RN (SHR 3.41, P < 0.001). Conclusions Despite similar survival, LP failure was associated with lower LCR and higher RN incidence, highlighting the need for optimized repeat SRS strategies.
引用
收藏
页码:85 / 95
页数:11
相关论文
共 46 条
[1]   Repeated in-field radiosurgery for locally recurrent brain metastases: Feasibility, results and survival in a heavily treated patient cohort [J].
Balermpas, Panagiotis ;
Stera, Susanne ;
von der Gruen, Jens Mueller ;
Loutfi-Krauss, Britta ;
Forster, Marie-Therese ;
Wagner, Marlies ;
Keller, Christian ;
Roedel, Claus ;
Seifert, Volker ;
Blanck, Oliver ;
Wolff, Robert .
PLOS ONE, 2018, 13 (06)
[2]   Radiation Therapy Practice Patterns for Brain Metastases in the United States in the Stereotactic Radiosurgery Era [J].
Barbour, Andrew B. ;
Jacobs, Corbin D. ;
Williamson, Hannah ;
Floyd, Scott R. ;
Suneja, Gita ;
Torok, Jordan A. ;
Kirkpatrick, John P. .
ADVANCES IN RADIATION ONCOLOGY, 2020, 5 (01) :43-52
[3]   Hippocampal Avoidance During Whole-Brain Radiotherapy Plus Memantine for Patients With Brain Metastases: Phase III Trial NRG Oncology CC001 [J].
Brown, Paul D. ;
Gondi, Vinai ;
Pugh, Stephanie ;
Tome, Wolfgang A. ;
Wefel, Jeffrey S. ;
Armstrong, Terri S. ;
Bovi, Joseph A. ;
Robinson, Cliff ;
Konski, Andre ;
Khuntia, Deepak ;
Grosshans, David ;
Benzinger, Tammie L. S. ;
Bruner, Deborah ;
Gilbert, Mark R. ;
Roberge, David ;
Kundapur, Vijayananda ;
Devisetty, Kiran ;
Shah, Sunjay ;
Usuki, Kenneth ;
Anderson, Bethany Marie ;
Stea, Baldassarre ;
Yoon, Harold ;
Li, Jing ;
Laack, Nadia N. ;
Kruser, Tim J. ;
Chmura, Steven J. ;
Shi, Wenyin ;
Deshmukh, Snehal ;
Mehta, Minesh P. ;
Kachnic, Lisa A. .
JOURNAL OF CLINICAL ONCOLOGY, 2020, 38 (10) :1019-+
[4]   Radiosurgical salvage therapy for patients presenting with recurrence of metastatic disease to the brain [J].
Chen, JCT ;
Petrovich, Z ;
Giannotta, SL ;
Yu, C ;
Apuzzo, MLJ .
NEUROSURGERY, 2000, 46 (04) :860-866
[5]   CAN STANDARD MAGNETIC RESONANCE IMAGING RELIABLY DISTINGUISH RECURRENT TUMOR FROM RADIATION NECROSIS AFTER RADIOSURGERY FOR BRAIN METASTASES? A RADIOGRAPHIC-PATHOLOGICAL STUDY [J].
Dequesada, Ivan M. ;
Quisling, Ronald G. ;
Yachnis, Anthony ;
Friedman, William A. .
NEUROSURGERY, 2008, 63 (05) :898-903
[6]   Sustained Preservation of Cognition and Prevention of Patient-Reported Symptoms With Hippocampal Avoidance During Whole- Brain Radiation Therapy for Brain Metastases : Final Results of NRG Oncology CC001 [J].
Gondi, Vinai ;
Deshmukh, Snehal ;
Wefel, Jeffrey S. ;
Armstrong, Terri S. ;
Tome, Wolfgang A. ;
Gilbert, Mark R. ;
Konski, Andre ;
Robinson, Clifford G. ;
Bovi, Joseph A. ;
Benzinger, Tammie L. S. ;
Roberge, David ;
Kundapur, Vijayananda ;
Kaufman, Isaac ;
Shah, Sunjay ;
Usuki, Kenneth Y. ;
Baschnagel, Andrew M. ;
Mehta, Minesh P. ;
Kachnic, Lisa A. ;
Brown, Paul D. .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2023, 117 (03) :571-580
[7]   Radiation Therapy for Brain Metastases: An ASTRO Clinical Practice Guideline [J].
Gondi, Vinai ;
Bauman, Glenn ;
Bradfield, Lisa ;
Burri, Stuart H. ;
Cabrera, Alvin R. ;
Cunningham, Danielle A. ;
Eaton, Bree R. ;
Hattangadi-Gluth, Jona A. ;
Kim, Michelle M. ;
Kotecha, Rupesh ;
Kraemer, Lianne ;
Li, Jing ;
Nagpal, Seema ;
Rusthoven, Chad G. ;
Suh, John H. ;
Tome, Wolfgang A. ;
Wang, Tony J. C. ;
Zimmer, Alexandra S. ;
Ziu, Mateo ;
Brown, Paul D. .
PRACTICAL RADIATION ONCOLOGY, 2022, 12 (04) :265-282
[8]   The Judicious Use of Stereotactic Radiosurgery and Hypofractionated Stereotactic Radiotherapy in the Management of Large Brain Metastases [J].
Gutschenritter, Tyler ;
Venur, Vyshak A. ;
Combs, Stephanie E. ;
Vellayappan, Balamurugan ;
Patel, Anoop P. ;
Foote, Matthew ;
Redmond, Kristin J. ;
Wang, Tony J. C. ;
Sahgal, Arjun ;
Chao, Samuel T. ;
Suh, John H. ;
Chang, Eric L. ;
Ellenbogen, Richard G. ;
Lo, Simon S. .
CANCERS, 2021, 13 (01) :1-15
[9]   Repeat stereotactic radiosurgery for the management of locally recurrent brain metastases [J].
Iorio-Morin, Christian ;
Mercure-Cyr, Rosalie ;
Figueiredo, Gabrielle ;
Touchette, Charles Jean ;
Masson-Cote, Laurence ;
Mathieu, David .
JOURNAL OF NEURO-ONCOLOGY, 2019, 145 (03) :551-559
[10]   A Second Course of Stereotactic Image-Guided Robotic Radiosurgery for Patients with Cerebral Metastasis [J].
Jiang, Xuechao ;
Wang, Hui ;
Song, Yongchun ;
Wang, Xiaoguang ;
Li, Fengtong ;
Dong, Yang ;
Wang, Jingsheng ;
Chen, Huaming ;
Yuan, Zhiyong .
WORLD NEUROSURGERY, 2019, 123 :E621-E628