Distance to isocenter is not associated with an increased risk for local failure in LINAC-based single-isocenter SRS or SRT for multiple brain metastases

被引：34

作者：

Kraft, Johannes ^{[1
,2
]}

van Timmeren, Janita E. ^{[1
]}

Mayinger, Michael ^{[1
]}

Frei, Simon ^{[1
]}

Borsky, Kim ^{[1
]}

Stark, Luisa Sabrina ^{[1
]}

Krayenbuehl, Jerome ^{[1
]}

Zamburlini, Mariangela ^{[1
]}

Guckenberger, Matthias ^{[1
]}

Tanadini-Lang, Stephanie ^{[1
]}

Andratschke, Nicolaus ^{[1
]}

机构：

[1] Univ Zurich, Univ Hosp Zurich, Dept Radiat Oncol, Zurich, Switzerland

[2] Univ Hosp Wuerzburg, Dept Radiat Oncol, Wurzburg, Germany

来源：

RADIOTHERAPY AND ONCOLOGY | 2021年 / 159卷

关键词：

Brain metastases; Radiosurgery; Stereotactic radiotherapy; Single isocenter multiple targets technique; VMAT; MODULATED STEREOTACTIC RADIOSURGERY; ROTATIONAL SETUP ERRORS; ARC RADIOSURGERY; TARGET VOLUME; FRAMELESS; MANAGEMENT; THERAPY; RADIOTHERAPY; PREDICTOR; ACCURACY;

D O I：

10.1016/j.radonc.2021.03.022

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: To evaluate the impact of the distance between treatment isocenter and brain metastases on local failure in patients treated with a frameless linear-accelerator-based single-isocenter volumetric modulated arc (VMAT) SRS/SRT for multiple brain metastases. Methods and materials: Patients treated with SRT for brain metastases (BM) between April 2014 and May 2019 were included in this retrospective study. BM treated with a single-isocenter multiple-target (SIMT) SRT were evaluated for local recurrence-free intervals in dependency to their distance to the treatment isocenter. A Cox-regression model was used to investigate different predictor variables for local failure. Results were compared to patients treated with a single-isocenter-single-target (SIST) approach. Results: In total 315 patients with a cumulative number of 1087 BM were analyzed in this study of which 140 patients and 708 BM were treated with SIMT SRS/SRT. Median follow-up after treatment was 13.9 months for SIMT approach and 11.9 months for SIST approach. One-year freedom from local recurrence was 87% and 94% in the SIST and SIMT group, respectively. Median distance to isocenter (DTI) was 4.7 cm (range 0.2-10.5) in the SIMT group. Local recurrence-free interval was not associated with the distance to the isocenter in univariable or multivariable Cox-regression analysis. Multivariable analysis revealed only volume as an independent significant predictor for local failure (p-value <0.05). Conclusion: SRS/SRT using single-isocenter VMAT for multiple targets achieved high local metastases control rates irrespective of distance to the isocenter, supporting efficacy of single-isocenter stereotactic radiation therapy for multiple brain metastases. (c) 2021 Elsevier B.V. All rights reserved. Radiotherapy and Oncology 159 (2021) 168-175

引用

页码：168 / 175

页数：8

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