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Intraoperative radiotherapy after neurosurgical resection of brain metastases as institutional standard treatment- update of the oncological outcome form a single center cohort after 117 procedures.
Kahl, Klaus-Henning; Krauss, Philipp E; Neu, Maria; Maurer, Christoph J; Schill-Reiner, Sabine; Roushan, Zoha; Laukmanis, Eva; Dobner, Christian; Janzen, Tilman; Balagiannis, Nikolaos; Sommer, Björn; Stüben, Georg; Shiban, Ehab.
Afiliación
  • Kahl KH; Department of Radiotherapy and Radio- Oncology, University Medical Center Augsburg, Augsburg, Germany. klaushenning.kahl@uk-augsburg.de.
  • Krauss PE; Department of Neurosurgery, University Medical Center Augsburg, Augsburg, Germany.
  • Neu M; Department of Radiotherapy and Radio- Oncology, University Medical Center Augsburg, Augsburg, Germany.
  • Maurer CJ; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Medical Center Augsburg, Augsburg, Germany.
  • Schill-Reiner S; Department of Medical Physics and Radiation Protection, University Medical Center Augsburg, Augsburg, Germany.
  • Roushan Z; Department of Medical Physics and Radiation Protection, University Medical Center Augsburg, Augsburg, Germany.
  • Laukmanis E; Department of Medical Physics and Radiation Protection, University Medical Center Augsburg, Augsburg, Germany.
  • Dobner C; Department of Medical Physics and Radiation Protection, University Medical Center Augsburg, Augsburg, Germany.
  • Janzen T; Department of Medical Physics and Radiation Protection, University Medical Center Augsburg, Augsburg, Germany.
  • Balagiannis N; Department of Radiotherapy and Radio- Oncology, University Medical Center Augsburg, Augsburg, Germany.
  • Sommer B; Department of Neurosurgery, University Medical Center Augsburg, Augsburg, Germany.
  • Stüben G; Department of Radiotherapy and Radio- Oncology, University Medical Center Augsburg, Augsburg, Germany.
  • Shiban E; Department of Neurosurgery, University Medical Center Augsburg, Augsburg, Germany.
J Neurooncol ; 169(1): 187-193, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38963657
ABSTRACT

PURPOSE:

Stereotactic radiotherapy (SRT) is the predominant method for the irradiation of resection cavities after resection of brain metastases (BM). Intraoperative radiotherapy (IORT) with 50 kV x-rays is an alternative way to irradiate the resection cavity focally. We have already reported the outcome of our first 40 IORT patients treated until 2020. Since then, IORT has become the predominant cavity treatment in our center due to patients´ choice.

METHODS:

We retrospectively analyzed the outcomes of all patients who underwent resection of BM and IORT between 2013 and August 2023 at Augsburg University Medical Center (UKA).

RESULTS:

We identified 105 patients with 117 resected BM treated with 50 kV x-ray IORT. Median diameter of the resected metastases was 3.1 cm (range 1.3 - 7.0 cm). Median applied dose was 20 Gy. All patients received standardized follow-up (FU) including three-monthly MRI of the brain. Mean FU was 14 months, with a median MRI FU for patients alive of nine months. Median overall survival (OS) of all treated patients was 18.2 months (estimated 1-year OS 57.7%). The observed local control (LC) rate of the resection cavity was 90.5% (estimated 1-year LC 84.2%). Distant brain control (DC) was 61.9% (estimated 1-year DC 47.9%). Only 16.2% of all patients needed WBI in the further course of disease. The observed radio necrosis rate was 2.6%.

CONCLUSION:

After 117 procedures IORT still appears to be a safe and appealing way to perform cavity RT after neurosurgical resection of BM with low toxicity and excellent LC.
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Texto completo: 1 Base de datos: MEDLINE Asunto principal: Neoplasias Encefálicas / Procedimientos Neuroquirúrgicos Idioma: En Revista: J Neurooncol / J. neurooncol / Journal of neuro-oncology Año: 2024 Tipo del documento: Article

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Neoplasias Encefálicas / Procedimientos Neuroquirúrgicos Idioma: En Revista: J Neurooncol / J. neurooncol / Journal of neuro-oncology Año: 2024 Tipo del documento: Article