title: Hypofractionated stereotactic radiotherapy for oligometastases in the brain: a single-institution experience.
abstract: The treatment of brain metastases is changing. Many different radiotherapy options are now available and under clinical evaluation. As part of this effort, we retrospectively evaluated the efficacy and toxicity of hypofractionated stereotactic radiotherapy (HSRT) in patients with up to three brain metastases. Sixty-five patients with 81 lesions were treated with hypofractionated radiotherapy. Median dose was 24 Gy in three fractions. Median follow-up was 24.6 months. Actuarial tumour control was 75 and 45% at 9 months and 24 months after treatment, respectively. Median survival time was 7.5 months, and 32% of the patients died from brain tumour progression. Actuarial overall survival was 75% at 3 months and 25% at 12 months. Recursive partitioning analysis class was the only significant prognostic factor. Neoadjuvant whole-brain radiotherapy (in 29 patients) had no impact on survival or local control. Neurological status improved in 42 patients (65%). Adverse events were rare and usually mild. This experience suggests HSRT should be considered as an alternative approach in the treatment of one to three metastatic lesions in selected patients.
authors.affiliation: Department of Neurosurgery, Division of Radiotherapy, Fondazione IRCCS Istituto Neurologico C Besta , Via Celoria 11, 20133 Milan, Italy. marchettimarcello@gmail.com
authors.forename: Marcello
authors.initials: M
authors.lastname: Marchetti
authors.forename: Ida
authors.initials: I
authors.lastname: Milanesi
authors.forename: Chiara
authors.initials: C
authors.lastname: Falcone
authors.forename: Michela
authors.initials: M
authors.lastname: De Santis
authors.forename: Luisa
authors.initials: L
authors.lastname: Fumagalli
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Brait
authors.forename: Livia
authors.initials: L
authors.lastname: Bianchi
authors.forename: Laura
authors.initials: L
authors.lastname: Fariselli
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000556:secondary* / Q000601:surgery; D018450:Disease Progression; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016634:Radiosurgery / Q000295:instrumentation / Q000379:methods*; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome