Efficacy and safety of fractionated stereotactic radiosurgery for large brain metastases

Won Joo Jeong, Jae Hong Park, Eun Jung Lee, Jeong Hoon Kim, Chang Jin Kim, Young Hyun Cho

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Objective: To investigate the efficacy and safety of fractionated stereotactic radiosurgery for large brain metastases (BMs). Methods: Between June 2011 and December 2013, a total of 38 large BMs >3.0 cm in 37 patients were treated with fractionated Cyberknife radiosurgery. These patients comprised 16 men (43.2%) and 21 women, with a median age of 60 years (range, 38–75 years). BMs originated from the lung (n=19, 51.4%), the gastrointestinal tract (n=10, 27.0%), the breast (n=5, 13.5%), and other tissues (n=3, 8.1%). The median tumor volume was 17.6 cc (range, 9.4–49.6 cc). For Cyberknife treatment, a median peripheral dose of 35 Gy (range, 30–41 Gy) was delivered in 3 to 5 fractions. Results: With a median follow-up of 10 months (range, 1–37 months), the crude local tumor control (LTC) rate was 86.8% and the estimated LTC rates at 12 and 24 months were 87.0% and 65.2%, respectively. The median overall survival (OS) and progression-free survival (PFS) rates were 16 and 11 months, respectively. The estimated OS and PFS rates at 6, 12, and 18 months were 81.1% and 65.5%, 56.8% and 44.9%, and 40.7% and 25.7%, respectively. Patient performance status and preoperative focal neurologic deficits improved in 20 of 35 (57.1%) and 12 of 17 patients (70.6%), respectively. Radiation necrosis with a toxicity grade of 2 or 3 occurred in 6 lesions (15.8%). Conclusion: These results suggest a promising role of fractionated stereotactic radiosurgery in treating large BMs in terms of both efficacy and safety.

Original languageEnglish
Pages (from-to)217-224
Number of pages8
JournalJournal of Korean Neurosurgical Society
Volume58
Issue number3
DOIs
StatePublished - Sep 2015
Externally publishedYes

Keywords

  • Brain metastases
  • Cyberknife
  • Fractionated stereotactic radiosurgery

Fingerprint Dive into the research topics of 'Efficacy and safety of fractionated stereotactic radiosurgery for large brain metastases'. Together they form a unique fingerprint.

  • Cite this