title: Hypofractionated stereotactic radiotherapy in combination with whole brain radiotherapy for brain metastases.
abstract: 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.
authors.affiliation: Department of Diagnostic Imaging, Tor Vergata University General Hospital, 00133, Rome, Italy. c.giubilei@libero.it
authors.forename: Cesare
authors.initials: C
authors.lastname: Giubilei
authors.forename: Gianluca
authors.initials: G
authors.lastname: Ingrosso
authors.forename: Marco
authors.initials: M
authors.lastname: D'Andrea
authors.forename: Michaela
authors.initials: M
authors.lastname: Benassi
authors.forename: Riccardo
authors.initials: R
authors.lastname: Santoni
mesh_terms: 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