Fractionated stereotactic radiotherapy of small intracranial malignancies

Citation
K. Tokuuye et al., Fractionated stereotactic radiotherapy of small intracranial malignancies, INT J RAD O, 42(5), 1998, pp. 989-994
Citations number
31
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Onconogenesis & Cancer Research
Journal title
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
ISSN journal
0360-3016 → ACNP
Volume
42
Issue
5
Year of publication
1998
Pages
989 - 994
Database
ISI
SICI code
0360-3016(199812)42:5<989:FSROSI>2.0.ZU;2-U
Abstract
Purpose: To retrospectively evaluate the effectiveness of fractionated ster eotactic radiotherapy (FSRT) in patients with small intracranial malignanci es. Methods and Materials: From July 1991 to March 1997, 80 patients with a tot al of 121 brain or skull-base tumors were treated with FSRT alone, and were followed for periods ranging from 3 to 62 months (median 9.8). The majorit y of patients received 42 Gy in 7 fractions over 2.3 weeks, but in July 199 3, protocols using smaller fraction doses were introduced for patients whos e radiation-field diameters were larger than 3 cm or whose tumors were clos e to critical normal tissues. Results: For 64 patients with metastatic brain tumors the overall median su rvival was 8.3 months and 1-year actuarial survival rate was 33%. Significa nt prognostic factors were: the presence of extracranial tumors, pre-treatm ent performance status, and the lung as a primary site. Patients without ex tracranial tumors prior to FSRT had a median survival of 21.2 months. For s even patients with high-grade glioma, 1-year actuarial local control rate w as 75%, with a median survival of 10.3 months. For patients with skull-base tumors the local control was achieved in 6 of 6 patients (100%), with a me dian survival of 30.7 months. No one suffered from acute complications, but three patients, two of whom had undergone FSRT as the third course of radi otherapy, developed late radiation injuries. Conclusion: Overall high local control and low morbidity rates suggest that FSRT is an effective and safe modality, even for those with a history of p rior irradiation. However,, patients with risk factors should be treated wi th smaller fraction doses. (C) 1998 Elsevier Science Inc.