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Title: Clinical outcome of hypofractionated conventional conformation radiotherapy for patients with single and no more than three metastatic brain tumors, with noninvasive fixation of the skull without whole brain irradiation

Abstract

Purpose: To evaluate the efficacy and toxicity of hypofractionated conventional conformation radiotherapy (HCCRT) with noninvasive fixation of the skull on patients with single or several brain metastases. Methods and Materials: The subjects were 44 patients who had three or fewer brain metastases (26 solitary, 18 multiple). Treatment was conducted on 65 metastases by rotational conformal beam or multiple fixed coplanar beams with a standard linear accelerator. The planning target volume consisted of the tumor and a 1-cm safety margin. The median isocentric dose was 24 Gy (range, 18-30 Gy) in 3-5 fractions. Whole-brain irradiation was not applied as an initial treatment. Results: Actuarial local tumor control rates at 6 months and 1 year were 78.4% and 71.9%, respectively. In-field recurrence was noted in 10 of 65 tumors, and repeat HCCRT was applied in 5 tumors. Actuarial overall survival rates at 1 year, 2 years, and the median survival time were 50.8%, 24.1%, and 5.8 months, respectively. The patients with an active primary cancer and poor performance status had a poorer prognosis than those without those factors. Actuarial freedom from second brain metastases rates at 6 months, 1 year, and 2 years were 86.6%, 69.0%, and 40.9%, respectively. Second brain metastasesmore » were observed in 9 of 44 patients. Lung adenocarcinomas had a higher risk of second brain metastasis than others. Treatment-related severe early or late complications were not observed in this series. Conclusions: Hypofractionated conventional conformation radiotherapy achieved sufficient tumor control and survival. The results suggest that HCCRT would be one of the alternatives for patients with either solitary or several brain metastases.« less

Authors:
 [1];  [2];  [2];  [2];  [2]
  1. Department of Radiology, Hirosaki University School of Medicine, Hirosaki, Aomori (Japan). E-mail: maoki-rad@umin.ac.jp
  2. Department of Radiology, Hirosaki University School of Medicine, Hirosaki, Aomori (Japan)
Publication Date:
OSTI Identifier:
20793299
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 64; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2005.03.017; PII: S0360-3016(05)00432-3; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRAIN; CARCINOMAS; IRRADIATION; LUNGS; METASTASES; PATIENTS; PERFORMANCE; RADIATION DOSES; RADIOTHERAPY; SAFETY MARGINS; SKULL; SURGERY; SURVIVAL TIME; TOXICITY

Citation Formats

Aoki, Masahiko, Abe, Yoshinao, Hatayama, Yoshiomi, Kondo, Hidehiro, and Basaki, Kiyoshi. Clinical outcome of hypofractionated conventional conformation radiotherapy for patients with single and no more than three metastatic brain tumors, with noninvasive fixation of the skull without whole brain irradiation. United States: N. p., 2006. Web. doi:10.1016/J.IJROBP.2005.0.
Aoki, Masahiko, Abe, Yoshinao, Hatayama, Yoshiomi, Kondo, Hidehiro, & Basaki, Kiyoshi. Clinical outcome of hypofractionated conventional conformation radiotherapy for patients with single and no more than three metastatic brain tumors, with noninvasive fixation of the skull without whole brain irradiation. United States. doi:10.1016/J.IJROBP.2005.0.
Aoki, Masahiko, Abe, Yoshinao, Hatayama, Yoshiomi, Kondo, Hidehiro, and Basaki, Kiyoshi. Wed . "Clinical outcome of hypofractionated conventional conformation radiotherapy for patients with single and no more than three metastatic brain tumors, with noninvasive fixation of the skull without whole brain irradiation". United States. doi:10.1016/J.IJROBP.2005.0.
@article{osti_20793299,
title = {Clinical outcome of hypofractionated conventional conformation radiotherapy for patients with single and no more than three metastatic brain tumors, with noninvasive fixation of the skull without whole brain irradiation},
author = {Aoki, Masahiko and Abe, Yoshinao and Hatayama, Yoshiomi and Kondo, Hidehiro and Basaki, Kiyoshi},
abstractNote = {Purpose: To evaluate the efficacy and toxicity of hypofractionated conventional conformation radiotherapy (HCCRT) with noninvasive fixation of the skull on patients with single or several brain metastases. Methods and Materials: The subjects were 44 patients who had three or fewer brain metastases (26 solitary, 18 multiple). Treatment was conducted on 65 metastases by rotational conformal beam or multiple fixed coplanar beams with a standard linear accelerator. The planning target volume consisted of the tumor and a 1-cm safety margin. The median isocentric dose was 24 Gy (range, 18-30 Gy) in 3-5 fractions. Whole-brain irradiation was not applied as an initial treatment. Results: Actuarial local tumor control rates at 6 months and 1 year were 78.4% and 71.9%, respectively. In-field recurrence was noted in 10 of 65 tumors, and repeat HCCRT was applied in 5 tumors. Actuarial overall survival rates at 1 year, 2 years, and the median survival time were 50.8%, 24.1%, and 5.8 months, respectively. The patients with an active primary cancer and poor performance status had a poorer prognosis than those without those factors. Actuarial freedom from second brain metastases rates at 6 months, 1 year, and 2 years were 86.6%, 69.0%, and 40.9%, respectively. Second brain metastases were observed in 9 of 44 patients. Lung adenocarcinomas had a higher risk of second brain metastasis than others. Treatment-related severe early or late complications were not observed in this series. Conclusions: Hypofractionated conventional conformation radiotherapy achieved sufficient tumor control and survival. The results suggest that HCCRT would be one of the alternatives for patients with either solitary or several brain metastases.},
doi = {10.1016/J.IJROBP.2005.0},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 2,
volume = 64,
place = {United States},
year = {Wed Feb 01 00:00:00 EST 2006},
month = {Wed Feb 01 00:00:00 EST 2006}
}