Linac-based radiosurgery or fractionated stereotactic radiotherapy with flattening filter-free volumetric modulated arc therapy in elderly patients : A mono-institutional experience on 110 brain metastases.
Strahlenther Onkol
; 195(3): 218-225, 2019 Mar.
Article
in En
| MEDLINE
| ID: mdl-30478669
ABSTRACT
AIM:
The aim of this study was to analyze the feasibility and clinical results of linear accelerator (linac-)based stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (SFRT) with flattening filter-free (FFF) volumetric modulated arc therapy (VMAT) in elderly patients affected by brain metastases (BMs). PATIENTS ANDMETHODS:
Patients selected for the present analysis were ≥65 years old with a life expectancy of >3 months, a controlled or synchronous primary tumor, and <10 BMs with a diameter <3â¯cm. All patients were treated with FFF linac-based SRS/SFRT. The prescribed total dose (15-30â¯Gy/1-5 fractions) was based on BM size and proximity to organs at risk (OAR). Toxicity was assessed according to the Common Terminology Criteria for Adverse Events (CTCAE) v4.0. MedCalc v18.2 (MedCalc Software, Ostend, Belgium) was used for statistical analysis.RESULTS:
From April 2014 to December 2017, 40 elderly patients with 110 BMs were treated by FFF linac-based SRS/SFRT. With a median follow-up of 28 months (range 6-50 months), median and 1year overall survival were 9 months and 39%, respectively; median intracranial progression-free survival was 6 months. At the time of the analysis, local control was reported in 109/110 BMs (99.1%) 12 BMs had a complete response; 51 a partial response; 46 showed stable disease. One BM (0.9%) progressed after 2 months. BM volume (<1â¯cc) and higher SRS/SFRT dose correlated to treatment response (pâ¯= 0.01 and pâ¯= 0.0017, respectively). No adverse events higher than grade 2 were observed.CONCLUSION:
The present findings highlight the feasibility, safety, and effectiveness of FFF linac-based SRS/SFRT in elderly patients with BMs.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Brain Neoplasms
/
Radiosurgery
/
Dose Fractionation, Radiation
/
Radiotherapy, Intensity-Modulated
Type of study:
Etiology_studies
Limits:
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
En
Journal:
Strahlenther Onkol
Journal subject:
NEOPLASIAS
/
RADIOTERAPIA
Year:
2019
Type:
Article
Affiliation country:
Italy