Treatment of brain oligometastases with hypofractionated stereotactic radiotherapy utilising volumetric modulated arc therapy

Croker, Jeremy, Chua, Benjamin, Bernard, Anne, Allon, Maryse and Foote, Matthew (2015) Treatment of brain oligometastases with hypofractionated stereotactic radiotherapy utilising volumetric modulated arc therapy. Clinical and Experimental Metastasis, 33 2: 125-132. doi:10.1007/s10585-015-9762-x


Author Croker, Jeremy
Chua, Benjamin
Bernard, Anne
Allon, Maryse
Foote, Matthew
Title Treatment of brain oligometastases with hypofractionated stereotactic radiotherapy utilising volumetric modulated arc therapy
Journal name Clinical and Experimental Metastasis   Check publisher's open access policy
ISSN 1573-7276
0262-0898
Publication date 2015-10-19
Year available 2015
Sub-type Article (original research)
DOI 10.1007/s10585-015-9762-x
Open Access Status Not yet assessed
Volume 33
Issue 2
Start page 125
End page 132
Total pages 8
Place of publication Dordrecht, Netherlands
Publisher Springer
Collection year 2016
Language eng
Formatted abstract
Stereotactic radiosurgery (SRS) is commonly used to treat brain metastases, particularly in the oligometastatic setting. This study analyses our initial experience in treating oligometastatic brain disease using Volumetric Modulated Arc Therapy (VMAT) to deliver hypofractionated stereotactic radiotherapy (HFSRT). Sixty-one patients were treated with HFSRT with a median dose of 24 Gy (range 22–40 Gy) in a median of three fractions (range 2–10 fractions). With a median follow-up of 23 months, the local control rate was 74 % for the entire cohort. Local control was 87 % for patients who had surgery with no radiological evidence of residual disease followed by HFSRT compared with 69 % in patients treated with HFSRT alone. The overall median time post radiotherapy to local failure was 8.6 months and to extracranial failure was 7.9 months. The mean time to distant brain failure was 9.9 months. Twenty-two patients (36 %) died during the study with median time to death of 4.4 months. Median overall survival (OS) from treatment was 21 months and 12 month OS was 60 %. Our experience with HFSRT using VMAT for oligometastatic brain metastases in the post-operative setting demonstrates comparable local control and survival rates compared with international published data. In the intact brain metastasis setting, local control using the dose levels and delivery in this cohort may be inferior to radio-surgical series. Local control is independent of histology. Careful selection of patients remains critical.
Keyword Stereotactic radiosurgery
Brain metastasis
Volumetric Modulated Arc Therapy
VMAT
Hypofractionation
Local control
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
Institute for Molecular Bioscience - Publications
 
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