Peri-radiosurgical administration of bevacizumab improves radiographic response to single and fractionated stereotactic radiosurgery for large brain metastasis

2021 ◽  
Author(s):  
Yi-Lun Chen ◽  
Abel Po-Hao Huang ◽  
Chia-Chun Wang ◽  
Hung-Yi Chen ◽  
Ya-Fang Chen ◽  
...  
Keyword(s):  
Brain Metastasis ◽  
Stereotactic Radiosurgery ◽  
Radiographic Response ◽  
Large Brain ◽  
Fractionated Stereotactic Radiosurgery

Fractionated Stereotactic Radiosurgery for Large Brain Metastases

2015 ◽  
Vol 38 (2) ◽  
pp. 135-139 ◽  
Author(s):  
Rodney E. Wegner ◽  
Jonathan E. Leeman ◽  
Peyman Kabolizadeh ◽  
Jean-Claude Rwigema ◽  
Arlan H. Mintz ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Large Brain ◽  
Fractionated Stereotactic Radiosurgery

scholarly journals Staged Stereotactic Radiosurgery Decreases Symptomatic Radionecrosis in Large Brain Metastasis

2021 ◽  
Vol 41 (3) ◽  
pp. 1445-1449
Author(s):  
NEIL CHEVLI ◽  
HUI-CHUAN WANG ◽  
PRACHI DUBEY ◽  
WAQAR HAQUE ◽  
ANDREW M. FARACH ◽  
...  
Keyword(s):  
Brain Metastasis ◽  
Stereotactic Radiosurgery ◽  
Large Brain

scholarly journals Efficacy and Safety of Fractionated Stereotactic Radiosurgery for Large Brain Metastases

2015 ◽  
Vol 58 (3) ◽  
pp. 217 ◽  
Author(s):  
Won Joo Jeong ◽  
Jae Hong Park ◽  
Eun Jung Lee ◽  
Jeong Hoon Kim ◽  
Chang Jin Kim ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Efficacy And Safety ◽  
Large Brain ◽  
Fractionated Stereotactic Radiosurgery

Fractionated Stereotactic Radiosurgery for Large Brain Metastases

2012 ◽  
Vol 84 (3) ◽  
pp. S303
Author(s):  
P. Kabolizadeh ◽  
R.E. Wegner ◽  
J.C. Rwigema ◽  
D.E. Heron ◽  
A.H. Mintz ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Large Brain ◽  
Fractionated Stereotactic Radiosurgery

scholarly journals MET-6 Neoadjuvant fractionated stereotactic radiotherapy followed by piecemeal resection for metastatic brain tumor

2021 ◽  
Vol 3 (Supplement_6) ◽  
pp. vi26-vi26
Author(s):  
Koichi Mitsuya ◽  
Shoichi Deguchi ◽  
Manabu Muto ◽  
Kazuaki Yasui ◽  
Tsuyoshi Onoe ◽  
...  
Keyword(s):  
Brain Metastasis ◽  
Stereotactic Radiosurgery ◽  
Stereotactic Radiotherapy ◽  
Progression Free Survival ◽  
Lesion Size ◽  
Fractionated Stereotactic Radiotherapy ◽  
Tumor Diameter ◽  
Whole Brain Radiation ◽  
Large Brain ◽  
Piecemeal Resection

Abstract BACKGROUND: Large brain metastases which require resection are treated with surgery followed by whole brain radiation therapy or postoperative stereotactic radiosurgery (SRS). Recently a novel strategy using neoadjuvant stereotactic radiosurgery (Na-SRS) followed by surgery was reported, demonstrating lower rates of postoperative leptomeningeal dissemination (LMD) and symptomatic radiation necrosis (RN). We treated with neoadjuvant fractionated stereotactic radiotherapy (Na-fSRT) followed by surgery for large brain metastasis with piecemeal resection. METHODS: Twelve patients received Na-fSRT followed by surgery between July 2019 and April 2021. Na-fSRT dose was based on lesion size and was standard dosing. Surgery generally followed within 7 days after radiotherapy. RESULTS: The mean age was 68 years (51–79). Sixteen men and five women. Mean follow-up period was 8.5 months (1–24.9). Primary were lung; 10 (NSCLC; 9, SCLC (recurrence); 1), esophagus; 3, colon; 2, melanoma; 2, kidney; 2 (recurrence1), uterus body; 1, and liver; 1. The median maximum tumor diameter was 3.6 cm (2.6–4.9). Median PTV, GTV volume were 21.7ml, 15.5ml, respectively. The median fSRT dose was 30Gy/5fr, and the median time from fSRT to surgery was 4 days (1–7). As preoperative adverse event, intracranial hypertension and partial seizure grade 2 (CTCAE ver.5) were occurred, but controlled with steroid and osmotic diuretics and anticonvulsant. Grade 3 and more adverse events were not occurred. Gross total removal was performed in 95.2%. Event cumulative incidence as follows: cavity local recurrence 4.8% (subtotal removal case); distant brain failure 33%; LMD 4.8%; and symptomatic RN 0%. The median intracranial progression free survival was 7 months, and median overall survival was 8.4 months. CONCLUSIONS: Na-fSRT followed by piecemeal resection is safety and feasible, and may have therapeutic value for deep large brain metastasis and eloquent lesion. Further prospective investigations in multi-institutional settings are warranted.

scholarly journals MET-02 Neoadjuvant fractionated stereotactic radiotherapy followed by surgery for large brain metastasis with difficulty in en-block resection

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii19-ii19
Author(s):  
Koichi Mitsuya ◽  
Shoichi Deguchi ◽  
Tsuyoshi Onoe ◽  
Kazuaki Yasui ◽  
Hirofumi Ogawa ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastasis ◽  
Small Cell Lung Cancer ◽  
Stereotactic Radiosurgery ◽  
Cell Lung Cancer ◽  
Stereotactic Radiotherapy ◽  
Small Cell ◽  
Fractionated Stereotactic Radiotherapy ◽  
Small Cell Lung ◽  
Large Brain

Abstract BACKGROUND: Large brain metastases which require resection are treated with surgery followed by whole brain radiation therapy or postoperative stereotactic radiosurgery (SRS). Recently a novel strategy using neoadjuvant stereotactic radiosurgery (Na-SRS) followed by surgery was reported, demonstrating lower rates of postoperative leptomeningeal dissemination (LMD) and symptomatic radiation necrosis (sRN). However, local control rate was not significantly improved. We treated with neoadjuvant fractionated stereotactic radiotherapy (Na-frSRT) followed by surgery for large brain metastasis with difficulty in en-block resection. METHODS: Nine patients received Na-frSRT followed by surgery between July 2019 and June 2020. Na-frSRT dose was based on lesion size and was standard dosing. Surgery generally followed within 7 days after radiotherapy. RESULTS: The mean age was 64 years (55–78). Eight men and one woman. Median follow-up period was 5.3 months (1.7–12.5). Primary cancers were non-small cell lung cancer 2, esophageal cancer 2, colon cancer 1, melanoma 1, hepato-cellular carcinoma 1 and recurrence of BM from small cell lung cancer and renal cell cancer. The median maximum tumor diameter was 4.3cm (2.6–4.9). The median SRT dose was 30Gy/5fr, and the median time from SRT to surgery was 4 days (1–7). Median PTV was 15.4ml (5.6–49.7), and median GTV was 21.7ml (8.6–61.4). As preoperative adverse event, intracranial hypertension grade2 (CTCAE ver.4.0) was occurred one patient, but controlled with steroid and osmotic diuretics. Grade 3 and more adverse events were not occurred. Gross total resection with intra-tumoral decompression and piece-meal technique was performed in all cases as planning. Event cumulative incidence as follows: surgical site recurrence 0%; local recurrence 11.1%; distant brain failure 11.1%; LMD 0%; and sRN 0%. The median overall survival was not reached. CONCLUSIONS: Na-frSRT followed by surgery is safety and feasible, and may have therapeutic value for large brain metastasis. Further prospective investigations in multi-institutional settings are warranted.

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