Ehret, Felix; Rueß, Daniel; Blanck, Oliver; Fichte, Susanne; Chatzikonstantinou, Georgios; Wolff, Robert; Mose, Lucas; Mose, Stephan; Fortmann, Thomas; Lehrke, Ralph; Turna, Menekse; Caglar, Hale Basak; Mortasawi, Farshin; Bleif, Martin; Krug, David; Ruge, Maximilian I; Fürweger, Christoph; Muacevic, Alexander (2024). Stereotactic radiosurgery and radiotherapy for brainstem metastases: An international multicenter analysis. International journal of cancer, 155(5), pp. 916-924. Wiley 10.1002/ijc.34980
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Intl_Journal_of_Cancer_-_2024_-_Ehret_-_Stereotactic_radiosurgery_and_radiotherapy_for_brainstem_metastases__An.pdf - Published Version Available under License Creative Commons: Attribution-Noncommercial (CC-BY-NC). Download (30MB) | Preview |
Brainstem metastases (BSM) present a significant neuro-oncological challenge, resulting in profound neurological deficits and poor survival outcomes. Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) offer promising therapeutic avenues for BSM despite their precarious location. This international multicenter study investigates the efficacy and safety of SRS and FSRT in 136 patients with 144 BSM treated at nine institutions from 2005 to 2022. The median radiographic and clinical follow-up periods were 6.8 and 9.4 months, respectively. Predominantly, patients with BSM were managed with SRS (69.4%). The median prescription dose and isodose line for SRS were 18 Gy and 65%, respectively, while for FSRT, the median prescription dose was 21 Gy with a median isodose line of 70%. The 12-, 24-, and 36-month local control (LC) rates were 82.9%, 71.4%, and 61.2%, respectively. Corresponding overall survival rates at these time points were 61.1%, 34.7%, and 19.3%. In the multivariable Cox regression analysis for LC, only the minimum biologically effective dose was significantly associated with LC, favoring higher doses for improved control (in Gy, hazard ratio [HR]: 0.86, p < .01). Regarding overall survival, good performance status (Karnofsky performance status, ≥90%; HR: 0.43, p < .01) and prior whole brain radiotherapy (HR: 2.52, p < .01) emerged as associated factors. In 14 BSM (9.7%), treatment-related adverse events were noted, with a total of five (3.4%) radiation necrosis. SRS and FSRT for BSM exhibit efficacy and safety, making them suitable treatment options for affected patients.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology |
UniBE Contributor: |
Mose, Lucas |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1097-0215 |
Publisher: |
Wiley |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
10 May 2024 12:21 |
Last Modified: |
06 Jul 2024 00:14 |
Publisher DOI: |
10.1002/ijc.34980 |
PubMed ID: |
38720427 |
Uncontrolled Keywords: |
brain metastasis brainstem fractionated stereotactic radiotherapy radiosurgery stereotactic radiosurgery |
BORIS DOI: |
10.48350/196660 |
URI: |
https://boris.unibe.ch/id/eprint/196660 |
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