Hypofractionated stereotactic radiotherapy in combination with whole brain radiotherapy for brain metastases.
BACKGROUND
The efficacy and toxicity of hypofractionated stereotactic radiotherapy (HSRT) in combination with whole brain radiotherapy (WBRT), for the treatment of 1-4 brain metastases, using a non invasive fixation of the skull, was investigated.


METHODS
Between 04/2001 and 01/2006 30 patients with 44 brain metastases underwent irradiation. Every patient received WBRT (10 x 3 Gy); 41/44 lesions received HSRT boost with a median dose fraction of 6 Gy, the fractionation schemes were 3 x 6 Gy and 4 x 8 Gy; a median total dose of 18 Gy was delivered to the tumor isocenter.


RESULTS
The median survival period was 9.15 months, the actuarial 1-year overall survival and freedom from new brain metastases were 36.6% and 87.9%, respectively; at univariate analysis Karnofsky Performance Status (KPS) was statistically significant (P = 0.05); the actuarial 1-year local control for the 41/44 lesions was 86.1%. No patient had acute or late complications.


CONCLUSIONS
HSRT as a concomitant boost during WBRT is a safe and well tolerated treatment for selected patients with brain metastases.
Giubilei
Cesare
C
Department of Diagnostic Imaging, Tor Vergata University General Hospital, 00133, Rome, Italy. c.giubilei@libero.it
Ingrosso
Gianluca
G
D'Andrea
Marco
M
Benassi
Michaela
M
Santoni
Riccardo
R
D000368:Aged; D001932:Brain Neoplasms / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery; D016371:Cranial Irradiation / Q000379:methods*; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology*; D016634:Radiosurgery; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D012189:Retrospective Studies; D016019:Survival Analysis