scholarly journals SURG-27. STEREOTACTIC LASER ABLATION (SLA) AS TREATMENT FOR BRAIN METASTASES THAT RECUR AFTER STEREOTACTIC RADIOSURGERY: A MULTI-INSTITUTIONAL EXPERIENCE

2016 ◽  
Vol 18 (suppl_6) ◽  
pp. vi196-vi196
Author(s):  
Clark Chen ◽  
Mir Amaan ◽  
Robert Rennert ◽  
Kate Carroll ◽  
Mayur Sharma ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Institutional Experience

scholarly journals CMET-41. OUTCOMES FOLLOWING STEREOTACTIC RADIOSURGERY (SRS) FOR LIMITED BRAIN METASTASES - AN AUSTRALIAN SINGLE INSTITUTIONAL EXPERIENCE

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi60-vi60
Author(s):  
Lilly Shen ◽  
Wee Loon Ong ◽  
Briana Farrugia ◽  
Anna Seeley ◽  
Carlos Augusto Gonzalvo ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Cumulative Incidence ◽  
Multivariate Analyses ◽  
Primary Lung Cancer ◽  
Factors Associated ◽  
Distant Failure ◽  
Kaplan Meier ◽  
Institutional Experience

Abstract INTRODUCTION Despite increasing use of stereotactic radiosurgery (SRS) for management of brain metastases (BM), published Australian data is scarce. We aim to report on the outcomes following SRS for limited BM in a single Australian institution. METHODS This is a retrospective cohort of patients with limited BM treated with SRS between August 2015 and March 2019. A dose of 24Gy/3# were prescribed to intact lesion, and 21Gy/3# to surgical cavity post-surgical resection. All patients were followed with 3-monthly surveillance MRI brain. Primary outcomes were: local failure (LF: increased in size of SRS-treated BM lesion/ recurrence in surgical cavity), distant failure (DF: intracranial progression outside of the SRS-treated lesion/ cavity), and overall survival (OS). LF, DF and OS were estimated using the Kaplan-Meier method. Multivariate Cox regressions were used to evaluate factors associated with outcomes of interest, with death as competing-risk events for LF and DF. RESULTS 76 courses of SRS were delivered in 65 patients (54 unresected BM lesions, and 22 surgical cavities). 43 (66%) patients were ECOG 0–1. 35 (54%) patients had solitary BM. 41 (63%) had symptomatic BM. Half of the patients had primary lung cancer. Median follow-up was 4.8 months (range:0.1–39 months). 10 LF were observed at a median of 3.5 month post-SRS, with 6- and 12-month LF cumulative incidence of 14% and 24% respectively. 30 DF were observed at a median of 3.3 months, with 6- and 12-month DF cumulative incidence of 38% and 63% respectively. The 12- and 24-month OS were 39% and 26% respectively. In multivariate analyses, better ECOG status, solitary BM lesion, resection of BM pre-SRS, and use of subsequent systemic therapy were independently associated with improved OS. CONCLUSION This is one of the few Australian series reporting on outcomes following SRS for limited BM, with comparable outcomes to published international series.

scholarly journals Stereotactic laser ablation as treatment for brain metastases that recur after stereotactic radiosurgery: a multiinstitutional experience

2016 ◽  
Vol 41 (4) ◽  
pp. E11 ◽  
Author(s):  
Mir Amaan Ali ◽  
Kate T. Carroll ◽  
Robert C. Rennert ◽  
Thomas Hamelin ◽  
Leon Chang ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Brain Metastases ◽  
Disease Progression ◽  
Stereotactic Radiosurgery ◽  
Corticosteroid Treatment ◽  
Significant Heterogeneity ◽  
Effective Treatment Option ◽  
Ablation Efficiency ◽  
Collective Experience ◽  
Risk Of Disease

OBJECTIVE Therapeutic options for brain metastases (BMs) that recur after stereotactic radiosurgery (SRS) remain limited. METHODS The authors provide the collective experience of 4 institutions where treatment of BMs that recurred after SRS was performed with stereotactic laser ablation (SLA). RESULTS Twenty-six BMs (in 23 patients) that recurred after SRS were treated with SLA (2 patients each underwent 2 SLAs for separate lesions, and a third underwent 2 serial SLAs for discrete BMs). Histological findings in the BMs treated included the following: breast (n = 6); lung (n = 6); melanoma (n = 5); colon (n = 2); ovarian (n = 1); bladder (n = 1); esophageal (n = 1); and sarcoma (n = 1). With a median follow-up duration of 141 days (range 64–794 days), 9 of the SLA-treated BMs progressed despite treatment (35%). All cases of progression occurred in BMs in which < 80% ablation was achieved, whereas no disease progression was observed in BMs in which ≥ 80% ablation was achieved. Five BMs were treated with SLA, followed 1 month later by adjuvant SRS (5 Gy daily × 5 days). No disease progression was observed in these patients despite ablation efficiency of < 80%, suggesting that adjuvant hypofractionated SRS enhances the efficacy of SLA. Of the 23 SLA-treated patients, 3 suffered transient hemiparesis (13%), 1 developed hydrocephalus requiring temporary ventricular drainage (4%), and 1 patient who underwent SLA of a 28.9-cm3 lesion suffered a neurological deficit requiring an emergency hemicraniectomy (4%). Although there is significant heterogeneity in corticosteroid treatment post-SLA, most patients underwent a 2-week taper. CONCLUSIONS Stereotactic laser ablation is an effective treatment option for BMs in which SRS fails. Ablation of ≥ 80% of BMs is associated with decreased risk of disease progression. The efficacy of SLA in this setting may be augmented by adjuvant hypofractionated SRS.

Stereotactic Laser Ablation as Treatment of Brain Metastases Recurring after Stereotactic Radiosurgery: A Systematic Literature Review

2019 ◽  
Vol 128 ◽  
pp. 134-142 ◽  
Author(s):  
Ali A. Alattar ◽  
Jiri Bartek ◽  
Veronica L. Chiang ◽  
Alireza M. Mohammadi ◽  
Gene H. Barnett ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Literature Review ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Systematic Literature Review

A multi-institutional experience with stereotactic radiosurgery for solitary brain metastases

1993 ◽  
Vol 27 ◽  
pp. 178-179
Author(s):  
John C. Flickinger ◽  
Douglas Kondziolka ◽  
L. Dade Lunsford ◽  
Robert J. Coffey ◽  
Michael L. Goodman ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Institutional Experience ◽  
Solitary Brain Metastases

scholarly journals Stereotactic Radiosurgery for Resected Brain Metastases: Single-Institutional Experience of over 500 Cavities

2019 ◽  
Vol 105 (1) ◽  
pp. E90 ◽  
Author(s):  
S. Shi ◽  
N. Sandhu ◽  
E.H. Wang ◽  
E. Liu ◽  
J. Abi Jaoude ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Institutional Experience

Stereotactic Radiosurgery for Resected Brain Metastases: Single-Institutional Experience of Over 500 Cavities

2020 ◽  
Vol 106 (4) ◽  
pp. 764-771 ◽  
Author(s):  
Siyu Shi ◽  
Navjot Sandhu ◽  
Michael C. Jin ◽  
Elyn Wang ◽  
Joseph Abi Jaoude ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Institutional Experience
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