scholarly journals A retrospective review of clinical outcome and hippocampus dosimetry in patients treated with stereotactic radiosurgery for brain metastases in South Wales

2018 ◽  
Vol 20 (suppl_1) ◽  
pp. i6-i6
Author(s):  
Najmus Sahar Iqbal ◽  
Owen Tilsley ◽  
Andrew Bryant ◽  
Anthony Millin ◽  
David G Lewis ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Retrospective Review ◽  
South Wales

Use of 3.0-T MRI for Stereotactic Radiosurgery Planning for Treatment of Brain Metastases: A Single-Institution Retrospective Review

2010 ◽  
Vol 78 (4) ◽  
pp. 1142-1146 ◽  
Author(s):  
Paul A. Saconn ◽  
Edward G. Shaw ◽  
Michael D. Chan ◽  
Sarah E. Squire ◽  
Annette J. Johnson ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Retrospective Review ◽  
Single Institution ◽  
3.0 T ◽  
3.0 T Mri

scholarly journals Single centre, retrospective review of gamma-knife stereotactic radiosurgery and other therapies on prevalence of seizures in patients with brain metastases

2019 ◽  
Vol 21 (Supplement_4) ◽  
pp. iv13-iv13
Author(s):  
James De Boisanger ◽  
Katherine Mackay ◽  
Cornel Tancu ◽  
Naomi Fersht ◽  
Neil Kitchen ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Gamma Knife ◽  
Retrospective Review ◽  
De Novo ◽  
Primary Tumour ◽  
Whole Brain Radiotherapy ◽  
Previous Surgery ◽  
Tumour Metastasis ◽  
Number Of Patients

Abstract Background An increasing number of patients with brain metastases (BM) are having stereotactic radiosurgery (SRS), but it is not known whether this causes epilepsy. Methods We carried out a retrospective review of patients surviving one-year post gamma-knife SRS at the National Hospital for Neurology and Neurosurgery (NHNN) between February 2012 and April 2017. Data on seizures during the pre- and post-SRS periods were collected along with information about the primary tumour, metastasis location and previous treatments, including whole brain radiotherapy (WBRT) and surgery. Results 61 patients were treated with SRS. 6 patients had incomplete records and were excluded. Of the remaining 55, 21 had a seizure at some point. 4 had seizures both pre- and post-SRS, 7 had seizures pre-SRS but not post and 10 patients had de-novo seizures post-SRS. 34 did not have a documented seizure at any point. Of the 14 patients who had seizures post-SRS, 4 also had both WBRT and surgery, 2 had WBRT and 4 had surgery. 100% (4/4) who had WBRT, surgery and SRS went on to have a seizure. Seizures occurred in 11/25 patients who had previous surgery and 7/11 who had previous WBRT. The primary tumour and metastasis location had no obvious impact on seizure incidence. Conclusions The incidence of new seizures post-SRS is low (18%). Previous surgery and/or WBRT may increase seizure incidence post-SRS. The data is currently being reviewed for effect of tumour/ treatment volume, dose delivered, presence of significant oedema and radionecrosis. A larger prospective study is also underway.

Post-operative stereotactic radiosurgery of brain metastases: A single-center retrospective review of clinical outcomes

2019 ◽  
Vol 19 (2) ◽  
pp. 127-131
Author(s):  
Zachary T. Smith ◽  
Syed U. Ashruf ◽  
Charles Mylander ◽  
Kerry J. Thompson ◽  
Charles Geraghty ◽  
...  
Keyword(s):  
Overall Survival ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Local Control ◽  
Retrospective Review ◽  
Categorical Variables ◽  
Community Practice ◽  
Continuous Variables ◽  
Survival Times ◽  
Single Fraction

AbstractAim:We sought to retrospectively report our outcomes using post-operative stereotactic radiosurgery (SRS)/stereotactic radiotherapy (SRT) in place of whole-brain radiation therapy (WBRT) following resection of brain metastases from our hospital-based community practice.Materials and Methods:A retrospective review of 23 patients who underwent post-operative SRS at our single institution from 2013 to 2017 was undertaken. Patient records, treatment plans and diagnostic images were reviewed. Local failure, distant intracranial failure and overall survival were studied. Categorical variables were analyzed using Fisher’s exact tests. Continuous variables were analyzed using Mann–Whitney tests. The Kaplan–Meier method was used to estimate survival times.Results:16 (70%) were single-fraction SRS, whereas the remaining 7 patients received a five-fraction treatment course. The median single-fraction dose was 16 Gy (range, 16–18). The median total dose for fractionated treatments was 25 Gy (range, 25–35). Overall survival at 6 and 12 months was 95 and 67%, respectively. Comparison of SRS versus SRT local control rates at 6 and 12 months revealed control rates of 92 and 78% versus 29 and 14%, respectively. Every patient with dural/pial involvement at the time of surgery had distant intracranial failure at the 12-month follow-up.Findings:Single-fraction frameless SRS proved to be an effective modality with excellent local control rates. However, the five-fraction SRT course was associated with an increased rate of local recurrence. Dural/pial involvement may portend a high risk for distant intracranial disease; therefore, it may be prudent to consider alternative approaches in these cases.

Clinical outcome of Russian HER2-positive breast cancer patients with brain metastases: Retrospective review.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. e13025-e13025 ◽  
Author(s):  
L.G. Zhukova ◽  
E. Lubennikova ◽  
I. Ganshina ◽  
A. H. Bekyashev ◽  
E. Kobyakova ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Outcome ◽  
Brain Metastases ◽  
Cancer Patients ◽  
Retrospective Review ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Her2 Positive Breast Cancer ◽  
Positive Breast Cancer

scholarly journals Quality of Automated Stereotactic Radiosurgery Plans in Patients with 4 to 10 Brain Metastases

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3458
Author(s):  
Anna Petoukhova ◽  
Roland Snijder ◽  
Rudolf Wiggenraad ◽  
Linda de Boer-de Wit ◽  
Ivonne Mudde-van der Wouden ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Irradiation Time ◽  
Intensity Modulated Radiotherapy ◽  
Pass Rate ◽  
Conformity Index ◽  
Index Gradient ◽  
Single Isocenter ◽  
Volumetric Modulated Arc Radiotherapy

The purpose was to compare linac-based stereotactic radiosurgery and hypofractionated radiotherapy plan quality of automated planning, intensity modulated radiotherapy (IMRT) and manual dynamic conformal arc (DCA) plans as well as single- and multiple-isocenter techniques for multiple brain metastases (BM). For twelve patients with four to ten BM, seven non-coplanar linac-based plans were created: a manually planned DCA plan with a separate isocenter for each metastasis, a single-isocenter dynamic IMRT plan, an automatically generated single-isocenter volumetric modulated arc radiotherapy (VMAT) plan, four automatically generated single-isocenter DCA plans with three or five couch angles, with high or low sparing of normal tissue. Paddick conformity index, gradient index (GI), mean dose, total V12Gy and V5Gy of uninvolved brain, number of monitor units (MUs), irradiation time and pass rate were compared. The GI was significantly higher for VMAT than for separate-isocenter, IMRT, and all automatically generated plans. The number of MUs was lowest for VMAT, followed by automatically generated DCA and IMRT plans and highest for manual DCA plans. Irradiation time was the shortest for automatically planned DCA plans. Automatically generated linac-based single-isocenter plans for multiple BM reduce the number of MUs and irradiation time with at least comparable GI and V5Gy relative to the reference separate-isocenter DCA plans.

LINAC-based stereotactic radiosurgery/radiotherapy for brain metastases in patients with breast cancer

2021 ◽  
pp. 1-9
Author(s):  
Ankita Gupta ◽  
Budhi Singh Yadav ◽  
Nagarjun Ballari ◽  
Namrata Das ◽  
Ngangom Robert
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Progression Free Survival ◽  
Rank Test ◽  
Karnofsky Performance Score ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Prior Surgery

Abstract Background: Brain metastases (BM) are common in patients with HER2-positive and triple-negative breast cancer. In this study we aim to report clinical outcomes with LINAC-based stereotactic radiosurgery/radiotherapy (SRS/SRT) for BM in patients of breast cancer. Methods: Clinical and dosimetric records of breast cancer patients treated for BM at our institute between May, 2015 and December, 2019 were retrospectively reviewed. Patients of previously treated or newly diagnosed breast cancer with at least a radiological diagnosis of BM; 1–4 in number, ≤3·5 cm in maximum dimension, with a Karnofsky Performance Score of ≥60 were taken up for treatment with SRS. SRT was generally considered if a tumour was >3·5 cm in diameter, near a critical or eloquent structure, or if the proximity of moderately sized tumours would lead to dose bridging in a single-fraction SRS plan. The median prescribed SRS dose was 15 Gy (range 7–24 Gy) and SRT dose was 27 Gy in 3 fractions. Clinical assessment and MR imaging was done at 6 weeks post-SRS and then every 3 months thereafter. Intracranial progression-free survival (PFS) and overall survival (OS) were calculated using Kaplan–Meier method and subgroups were compared using log rank test. Results: Total, 40 tumours were treated in 31 patients. The median tumour diameter was 2·3 cm (range 1·0–4·6 cm). SRS and SRT were delivered in 27 and 4 patients, respectively. SRS/SRT was given as a boost to whole brain radiotherapy (WBRT) in four patients and as salvage for progression after WBRT in six patients. In general, nine patients underwent prior surgery. The median follow-up was 7·9 months (0·2–34 months). Twenty (64·5%) patients developed local recurrence, 10 (32·3%) patients developed distant intracranial relapse and 7 patients had both local and distant intracranial relapse. The estimated local control at 6 months and 1 year was 48 and 35%, respectively. Median intracranial progression free survival (PFS) was 3·73 months (range 0·2–25 months). Median intracranial PFS was 3·02 months in patients who received SRS alone or as boost after WBRT, while it was 4·27 months in those who received SRS as salvage after WBRT (p = 0·793). No difference in intracranial PFS was observed with or without prior surgery (p = 0·410). Median overall survival (OS) was 21·7 months (range 0·2–34 months) for the entire cohort. Patients who received prior WBRT had a poor OS (13·31 months) as compared to SRS alone (21·4 months; p = 0·699). Conclusion: In patients with BM after breast cancer SRS alone, WBRT + SRS and surgery + SRS had comparable PFS and OS.

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