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Hypofractionated stereotactic radiotherapy for brain metastases from lung cancer : Evaluation of indications and predictors of local control.
Ishihara, Takeaki; Yamada, Kazunari; Harada, Aya; Isogai, Kenta; Tonosaki, Yoshihiro; Demizu, Yusuke; Miyawaki, Daisuke; Yoshida, Kenji; Ejima, Yasuo; Sasaki, Ryohei.
Afiliação
  • Ishihara T; Division of Radiation Oncology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan. spz694w9@onyx.ocn.ne.jp.
  • Yamada K; Department of Radiation Oncology, Seirei Mikatahara General Hospital, Shizuoka, Japan. spz694w9@onyx.ocn.ne.jp.
  • Harada A; Department of Radiation Oncology, Seirei Mikatahara General Hospital, Shizuoka, Japan.
  • Isogai K; Department of Radiation Oncology, Kobe Minimum Invasive Cancer Medical Center, Hyogo, Japan.
  • Tonosaki Y; Department of Radiation Oncology, Seirei Mikatahara General Hospital, Shizuoka, Japan.
  • Demizu Y; Department of Radiation Oncology, Seirei Mikatahara General Hospital, Shizuoka, Japan.
  • Miyawaki D; Department of Radiology, Hyogo Ion Beam Medical Center, Hyogo, Japan.
  • Yoshida K; Division of Radiation Oncology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan.
  • Ejima Y; Division of Radiation Oncology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan.
  • Sasaki R; Division of Radiation Oncology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan.
Strahlenther Onkol ; 192(6): 386-93, 2016 Jun.
Article em En | MEDLINE | ID: mdl-27169391
ABSTRACT

AIM:

To evaluate the efficacy and toxicity of hypofractionated stereotactic radiotherapy (HSRT) for brain metastases (BMs) from lung cancer, and to explore prognostic factors associated with local control (LC) and indication. PATIENTS AND

METHODS:

We evaluated patients who were treated with linac-based HSRT for BMs from lung cancer. Lesions treated with stereotactic radiosurgery (SRS) in the same patients during the same periods were analysed and compared with HSRT in terms of LC or toxicity. There were 53 patients with 214 lesions selected for this analysis (HSRT 76 lesions, SRS 138 lesions). For HSRT, the median prescribed dose was 35 Gy in 5 fractions.

RESULTS:

The 1­year LC rate was 83.6 % in HSRT; on multivariate analysis, a planning target volume (PTV) of <4 cm(3), biologically effective dose (BED10) of ≥51 Gy, and adenocarcinoma were significantly associated with better LC. Moreover, in PTVs ≥ 4 cm(3), there was a significant difference in LC between BED10 < 51 Gy and ≥ 51 Gy (p = 0.024). On the other hand, in PTVs < 4 cm(3), both HSRT and SRS had good LC with no significant difference (p = 0.195). Radiation necrosis emerged in 5 of 76 lesions (6.6 %) treated with HSRT and 21 of 138 (15.2 %) lesions treated with SRS (p = 0.064).

CONCLUSION:

Linac-based HSRT was safe and effective for BMs from lung cancer, and hence might be particularly useful in or near an eloquent area. PTV, BED10, and pathological type were significant prognostic factors. Furthermore, in BMs ≥ 4 cm(3), a dose of BED ≥ 51 Gy should be considered.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Encefálicas / Radiocirurgia / Hipofracionamento da Dose de Radiação / Neoplasias Pulmonares / Recidiva Local de Neoplasia Tipo de estudo: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País como assunto: Asia Idioma: En Ano de publicação: 2016 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Encefálicas / Radiocirurgia / Hipofracionamento da Dose de Radiação / Neoplasias Pulmonares / Recidiva Local de Neoplasia Tipo de estudo: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País como assunto: Asia Idioma: En Ano de publicação: 2016 Tipo de documento: Article