Fractionated stereotactic radiotherapy of intracranial postoperative cavities after resection of brain metastases – Clinical outcome and prognostic factors

• DOI: 10.1016/j.ctro.2024.100782
• Publication Date: 2024-04-21T05:18:52Z
• Authors: L. Hahnemann; A. Krämer; C. Fink; C. Jungk; M. Thomas; P. Christopoulos; J.W. Lischalk; J. Meis; J. Hörner-Rieber; T. Eichkorn; M. Deng; K. Lang; A. Paul; E. Meixner; F. Weykamp; J. Debus; L. König
• Keywords: Surgical resection

Background and Purpose After surgical resection of brain metastases (BM), radiotherapy (RT) is indicated. Postoperative stereotactic radiosurgery (SRS) reduces the risk local progression neurocognitive decline compared to whole (WBRT). Aside from optimal dose fractionation, little known about combination systemic therapy postoperative fractionated (fSRT), especially regarding tumour control toxicity. Methods In this study, 105 patients receiving fSRT with 35 Gy in 7 fractions performed Cyberknife were retrospectively reviewed. Overall survival (OS), (LC) total intracranial (TIBC) analysed via Kaplan-Meier method. Cox proportional hazards models used identify prognostic factors.Results Median follow-up was 20.8 months. One-year TIBC 61.6% one-year LC 98.6%. OS 28.7 (95%-CI: 16.9–40.5) total, (median time not reached) occurred 2.0% 20.4% radiationinduced contrast enhancements (RICE) cavity (after median 14.3 months) diagnosed. Absence extracranial identified as an independent factor for superior (p = <0.001) multivariate analyses, while a higher Karnofsky performance score (KPS) predictive longer univariate analysis 0.041). Leptomeningeal disease (LMD) developed 13% patients.Conclusion FSRT after BM effective safe treatment approach excellent acceptable Further prospective randomized trials are needed establish standardized therapeutic guidelines.