Efficacy and safety of hypofractionated stereotactic radiotherapy for brain metastases using three fractions: A single-centre retrospective study

Purpose - Hypofractionated stereotactic radiotherapy (HFSRT) has become a standard of care for patientswith a limited number of brain metastases (BM). An increasing number of linear accelerators (LA) areable to accurately perform HFSRT including VersaHD (R) (Elekta (R)) LA. The main aim of this study was toreport clinical outcomes of BM treated by HFSRT using 3 x 7.7 Gy on 70% isodose line in terms of localcontrol (LC). Patients and methods. - Between November 2016 and October 2018, all patients suffering fromhistologicallyproven primary with one or several newly diagnosed BM treated by HFSRT were retrospectively included and evaluated. Patients who had received prior treatment by neurosurgery or cerebralradiotherapy were excluded. Results. - Among 44 patients, 61 BM were treated. With a median follow-up of 31.9 months, LC ratesat 6 and 12 months were 93.2% and 90.9, respectively. Single-BM was independently predictive of LC( P = 0.025) and overall survival (P = 0.013). Acute toxicity rates were acceptable: 65.9% of patients hadgrade 1 and 2 and no acute grade 3 toxicity according to the NCI-CTCAE (version 5.0). Regarding delayedtoxicity, one case (2.3%) of radionecrosis was confirmed by magnetic resonance spectroscopy. Conclusion. - In our single-centre retrospective analysis, BM treatment by HFSRT delivered in three fractions showed a 12-month LC rate of 90.9% without major toxicities, which suggests safety and efficiencyof this technique. However, longer-term follow-up and prospective studies are still needed to confirmthese results. (c) 2021 Societe francaise de radiotherapie oncologique (SFRO). Published by Elsevier Masson SAS. Allrights reserved.