Three- and four-year cognitive outcome in children with noncortical brain tumors treated with whole-brain radiotherapy

1992 ◽  
Vol 32 (4) ◽  
pp. 551-554 ◽  
Author(s):  
Jerilynn Radcliffe ◽  
Roger J. Packer ◽  
Thomas E. Atkins ◽  
Greta R. Bunin ◽  
Luis Schut ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Whole Brain Radiotherapy ◽  
Cognitive Outcome ◽  
Whole Brain ◽  
Brain Radiotherapy

Gamma Knife surgery for metastatic brain tumors without prophylactic whole-brain radiotherapy: results in 1000 consecutive cases

2006 ◽  
Vol 105 (Supplement) ◽  
pp. 86-90 ◽  
Author(s):  
Toru Serizawa ◽  
Yoshinori Higuchi ◽  
Junichi Ono ◽  
Shinji Matsuda ◽  
Osamu Nagano ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Brain Metastases ◽  
Gamma Knife ◽  
Whole Brain Radiotherapy ◽  
Gamma Knife Surgery ◽  
Carcinomatous Meningitis ◽  
Metastatic Brain Tumors ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
Extracranial Disease

ObjectThe authors analyzed the effectiveness of Gamma Knife surgery (GKS) for metastatic brain tumors without adjuvant prophylactic whole-brain radiotherapy (WBRT). Salvage GKS was performed as the sole treatment for new distant lesions.MethodsAmong 1127 patients in whom new brain metastases had been diagnosed, 97 who met one or more of the following three criteria were excluded from the study: any surgically inaccessible huge (≥ 35 mm) lesion; tumor number and size requiring an internal skull dose exceeding 10 J; or symptomatic carcinomatous meningitis. Thus, 1030 consecutive patients formed the basis for this study. Huge tumors were totally removed, whereas smaller lesions were treated with GKS. No adjuvant WBRT was given prior to GKS, and new distant lesions were appropriately retreated with GKS. Overall, neurological and new lesion–free survival curves were calculated and the prognostic values of covariates were obtained. In total, 1853 separate GKS sessions were required to treat 10,163 lesions.The patients' median overall survival period was 8.6 months. Neurological survival and new lesion–free rates at 1 year were 89.1 and 49.3%, respectively. In a multivariate analysis, the significant factors for poor prognosis were the development of more than four new brain metastases and active extracranial disease.Conclusions In meeting the goal of preventing neurological death and maintaining activities of daily living for patients with brain metastases, GKS alone provides excellent palliation without prophylactic WBRT. New distant lesions were quite well controlled with GKS salvage treatment alone.

scholarly journals Re-irradiation for Metastatic Brain Tumors with Whole-brain Radiotherapy

2012 ◽  
Vol 42 (4) ◽  
pp. 264-269 ◽  
Author(s):  
T. Akiba ◽  
E. Kunieda ◽  
A. Kogawa ◽  
T. Komatsu ◽  
Y. Tamai ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Whole Brain Radiotherapy ◽  
Metastatic Brain Tumors ◽  
Whole Brain ◽  
Brain Radiotherapy

Novel Strategy in the Radiotherapy of Metastatic Brain Tumors: Simultaneous Whole Brain Radiotherapy and Integrated Stereotactic Radiosurgery

2015 ◽  
Vol 68 (11-12) ◽  
pp. 391-397
Author(s):  
Judit Kalincsák ◽  
Zoltán László ◽  
Zsolt Sebestyén ◽  
Péter Kovács ◽  
Zsolt Horváth ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Stereotactic Radiosurgery ◽  
Whole Brain Radiotherapy ◽  
Metastatic Brain Tumors ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
Novel Strategy

Novel Strategy in the Radiotherapy of Metastatic Brain Tumors: Simultaneous Whole Brain Radiotherapy and Integrated Stereotactic Radiosurgery

2015 ◽  
Vol 68 (11-12) ◽  
pp. 391-397
Author(s):  
Judit Kalincsák ◽  
Zoltán László ◽  
Zsolt Sebestyén ◽  
Péter Kovács ◽  
Zsolt Horváth ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Stereotactic Radiosurgery ◽  
Whole Brain Radiotherapy ◽  
Metastatic Brain Tumors ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
Novel Strategy

scholarly journals Use of a Head-Tilting Baseplate During Tomotherapy to Shorten the Irradiation Time and Protect the Hippocampus and Lens in Hippocampal Sparing-Whole Brain Radiotherapy

2021 ◽  
Vol 20 ◽  
pp. 153303382098682
Author(s):  
Kosei Miura ◽  
Hiromasa Kurosaki ◽  
Nobuko Utsumi ◽  
Hideyuki Sakurai
Keyword(s):  
At Risk ◽  
Planning Target Volume ◽  
Irradiation Time ◽  
Organs At Risk ◽  
Absorbed Dose ◽  
Whole Brain Radiotherapy ◽  
Target Volume ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
Hippocampal Sparing

Purpose: The aim of this study is to comparatively examine the possibility of reducing the exposure dose to organs at risk, such as the hippocampus and lens, and improving the dose distribution of the planned target volume with and without the use of a head-tilting base plate in hippocampal-sparing whole-brain radiotherapy using tomotherapy. Methods: Five paired images of planned head computed tomography without and with tilt were analyzed. The hippocampus and planning target volume were contoured according to the RTOG 0933 contouring atlas protocol. The hippocampal zone to be avoided was delineated using a 5-mm margin. The prescribed radiation dose was 30 Gy in 10 fractions. The absorbed dose to planning target volume dose, absorbed dose to the organ at risk, and irradiation time were evaluated. The paired t-test was used to analyze the differences between hippocampal-sparing whole-brain radiotherapy with head tilts and without head tilts. Results: Hippocampal-sparing whole-brain radiotherapy with tilt was not superior in planning target volume doses using the homogeneity index than that without tilt; however, it showed better values, and for Dmean and D2%, the values were closer to 30 Gy. Regarding the hippocampus, dose reduction with tilt was significantly greater at Dmax, Dmean, and Dmin, whereas regarding the lens, it was significantly greater at Dmax and Dmin. The irradiation time was also predominantly shorter. Conclusion: In our study, a tilted hippocampal-sparing whole-brain radiotherapy reduced the irradiation time by >10%. Therefore, our study indicated that hippocampal-sparing whole-brain radiotherapy with tomotherapy should be performed with a tilt. The head-tilting technique might be useful during hippocampal-sparing whole-brain radiotherapy. This method could decrease the radiation exposure time, while sparing healthy organs, including the hippocampus and lens.

scholarly journals A Dutch phase III randomized multicenter trial: whole brain radiotherapy vs. stereotactic radiotherapy for 4-10 brain metastases

2021 ◽  
Author(s):  
Dianne Hartgerink ◽  
Anna Bruynzeel ◽  
Danielle Eekers ◽  
Ans Swinnen ◽  
Coen Hurkmans ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Brain Metastases ◽  
Survival Rates ◽  
Whole Brain Radiotherapy ◽  
Phase Iii ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
One Year

Abstract Background The clinical value of whole brain radiotherapy (WBRT) for brain metastases (BM) is a matter of debate due to the significant side effects involved. Stereotactic radiosurgery (SRS) is an attractive alternative treatment option that may avoid these side effects and improve local tumor control. We initiated a randomized trial (NCT02353000) to investigate whether quality of life is better preserved after SRS compared with WBRT in patients with multiple brain metastases. Methods Patients with 4 to 10 BM were randomized between the standard arm WBRT (total dose 20 Gy in 5 fractions) or SRS (single fraction or 3 fractions). The primary endpoint was the difference in quality of life (QOL) at three months post-treatment. Results The study was prematurely closed due to poor accrual. A total of 29 patients (13%) were randomized, of which 15 patients have been treated with SRS and 14 patients with WBRT. The median number of lesions were 6 (range, 4-9) and the median total treatment volume was 13.0 cc 3 (range, 1.8-25.9 cc 3). QOL at three months decreased in the SRS group by 0.1 (SD=0.2), compared to 0.2 (SD=0.2) in the WBRT group (p=0.23). The actuarial one-year survival rates were 57% (SRS) and 31% (WBRT) (p=0.52). The actuarial one-year brain salvage-free survival rates were 50% (SRS) and 78% (WBRT) (p=0.22). Conclusion In patients with 4 to 10 BM, SRS alone resulted in one-year survival for 57% of patients while maintaining quality of life. Due to the premature closure of the trial, no statistically significant differences could be determined.

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