Second course of stereotactic radiosurgery for locally recurrent brain metastases: Safety and efficacy

• DOI: 10.1371/journal.pone.0195608
• Publication Date: 2018-04-05T21:55:27Z
• Authors: Juliette Moreau; Toufic Khalil; Guillaume Dupic; Emmanuel Chautard; Jean-Jacques Lemaire; Florian Magnier; Véronique Dedieu; Michel Lapeyre; Pierre Verrelle; Julian Biau
• Keywords: Univariate analysis

In the present study, we have evaluated efficacy and toxicity of repeated brain metastases (BM) stereotactic radiosurgery (SRS2) following local failure a prior radiosurgical procedure (SRS1). Between December 1996 August 2015, 30 patients with 36 BM underwent SRS2 median dose 18Gy. All were located outside critical structures. Following SRS2, control at 6 months one year respectively 82.9% (IC 95%: 67.6–91.9) 67.8% 51–81). On multivariate analysis, planning target volume (PTV) < 3cc (HR: 0.19 (0.1–0.52)) whole radiotherapy (WBRT) to 0.25 (0.1–0.64)) significantly associated better control. One- two-year overall survival rates after 65.5% 47.3–80%) 27.6% 14.7–45.7). Median was 14.2 (range 1–106). Nineteen (63%) died from progressive systemic disease. Three (10%) out-field disease 8 (27%) in-field. Concerning toxicities, edema, radionecrosis, hemorrhages identified in 5 (12.8%), 4 (10.2%), (12.8%) respectively. No resulted neurological deficit. univariate toxicities PTV > 7cc (p = 0.02) all had WBRT before SRS2. A second course SRS for locally recurrent showed encouraging This treatment led acceptable especially smaller than 7cc, our selected cohort Further studies are needed.