TY - JOUR
T1 - Stereotactic Radiosurgery for Brainstem Metastases
T2 - An International Cooperative Study to Define Response and Toxicity
AU - Trifiletti, Daniel M.
AU - Lee, Cheng Chia
AU - Kano, Hideyuki
AU - Cohen, Jonathan
AU - Janopaul-Naylor, James
AU - Alonso-Basanta, Michelle
AU - Lee, John Y.K.
AU - Simonova, Gabriela
AU - Liscak, Roman
AU - Wolf, Amparo
AU - Kvint, Svetlana
AU - Grills, Inga S.
AU - Johnson, Matthew
AU - Liu, Kang Du
AU - Lin, Chung Jung
AU - Mathieu, David
AU - Héroux, France
AU - Silva, Danilo
AU - Sharma, Mayur
AU - Cifarelli, Christopher P.
AU - Watson, Christopher N.
AU - Hack, Joshua D.
AU - Golfinos, John G.
AU - Kondziolka, Douglas
AU - Barnett, Gene
AU - Lunsford, L. Dade
AU - Sheehan, Jason P.
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Purpose To pool data across multiple institutions internationally and report on the cumulative experience of brainstem stereotactic radiosurgery (SRS). Methods and Materials Data on patients with brainstem metastases treated with SRS were collected through the International Gamma Knife Research Foundation. Clinical, radiographic, and dosimetric characteristics were compared for factors prognostic for local control (LC) and overall survival (OS) using univariate and multivariate analyses. Results Of 547 patients with 596 brainstem metastases treated with SRS, treatment of 7.4% of tumors resulted in severe SRS-induced toxicity (grade ≥3, increased odds with increasing tumor volume, margin dose, and whole-brain irradiation). Local control at 12 months after SRS was 81.8% and was improved with increasing margin dose and maximum dose. Overall survival at 12 months after SRS was 32.7% and impacted by age, gender, number of metastases, tumor histology, and performance score. Conclusions Our study provides additional evidence that SRS has become an option for patients with brainstem metastases, with an excellent benefit-to-risk ratio in the hands of experienced clinicians. Prior whole-brain irradiation increases the risk of severe toxicity in brainstem metastasis patients undergoing SRS.
AB - Purpose To pool data across multiple institutions internationally and report on the cumulative experience of brainstem stereotactic radiosurgery (SRS). Methods and Materials Data on patients with brainstem metastases treated with SRS were collected through the International Gamma Knife Research Foundation. Clinical, radiographic, and dosimetric characteristics were compared for factors prognostic for local control (LC) and overall survival (OS) using univariate and multivariate analyses. Results Of 547 patients with 596 brainstem metastases treated with SRS, treatment of 7.4% of tumors resulted in severe SRS-induced toxicity (grade ≥3, increased odds with increasing tumor volume, margin dose, and whole-brain irradiation). Local control at 12 months after SRS was 81.8% and was improved with increasing margin dose and maximum dose. Overall survival at 12 months after SRS was 32.7% and impacted by age, gender, number of metastases, tumor histology, and performance score. Conclusions Our study provides additional evidence that SRS has become an option for patients with brainstem metastases, with an excellent benefit-to-risk ratio in the hands of experienced clinicians. Prior whole-brain irradiation increases the risk of severe toxicity in brainstem metastasis patients undergoing SRS.
UR - http://www.scopus.com/inward/record.url?scp=84979747827&partnerID=8YFLogxK
U2 - 10.1016/j.ijrobp.2016.06.009
DO - 10.1016/j.ijrobp.2016.06.009
M3 - Article
C2 - 27478166
AN - SCOPUS:84979747827
SN - 0360-3016
VL - 96
SP - 280
EP - 288
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 2
ER -
