Title: Single-Isocenter Frameless Intensity-Modulated Stereotactic Radiosurgery for Simultaneous Treatment of Multiple Brain Metastases: Clinical Experience
Abstract: Purpose To describe our clinical experience using a unique single-isocenter technique for frameless intensity-modulated stereotactic radiosurgery (IM-SRS) to treat multiple brain metastases. Methods and Materials Twenty-six patients with a median of 5 metastases (range, 2–13) underwent optically guided frameless IM-SRS using a single, centrally located isocenter. Median prescription dose was 18 Gy (range, 14–25). Follow-up magnetic resonance imaging (MRI) and clinical examination occurred every 2–4 months. Results Median follow-up for all patients was 3.3 months (range, 0.2–21.3), with 20 of 26 patients (77%) followed up until their death. For the remaining 6 patients alive at the time of analysis, median follow-up was 14.6 months (range, 9.3–18.0). Total treatment time ranged from 9.0 to 38.9 minutes (median, 21.0). Actuarial 6- and 12-month overall survivals were 50% (95% confidence interval [C.I.], 31–70%) and 38% (95% C.I., 19–56%), respectively. Actuarial 6- and 12-month local control (LC) rates were 97% (95% C.I., 93–100%) and 83% (95% C.I., 71–96%), respectively. Tumors ≤1.5 cm had a better 6-month LC than those >1.5 cm (98% vs. 90%, p = 0.008). New intracranial metastatic disease occurring outside of the treatment volume was observed in 7 patients. Grade ≥3 toxicity occurred in 2 patients (8%). Conclusion Frameless IM-SRS using a single-isocenter approach for treating multiple intracranial metastases can produce clinical outcomes that compare favorably with those of conventional SRS in a much shorter treatment time (<40 minutes). Given its faster treatment time, this technique is appealing to both patients and personnel in busy clinics. To describe our clinical experience using a unique single-isocenter technique for frameless intensity-modulated stereotactic radiosurgery (IM-SRS) to treat multiple brain metastases. Twenty-six patients with a median of 5 metastases (range, 2–13) underwent optically guided frameless IM-SRS using a single, centrally located isocenter. Median prescription dose was 18 Gy (range, 14–25). Follow-up magnetic resonance imaging (MRI) and clinical examination occurred every 2–4 months. Median follow-up for all patients was 3.3 months (range, 0.2–21.3), with 20 of 26 patients (77%) followed up until their death. For the remaining 6 patients alive at the time of analysis, median follow-up was 14.6 months (range, 9.3–18.0). Total treatment time ranged from 9.0 to 38.9 minutes (median, 21.0). Actuarial 6- and 12-month overall survivals were 50% (95% confidence interval [C.I.], 31–70%) and 38% (95% C.I., 19–56%), respectively. Actuarial 6- and 12-month local control (LC) rates were 97% (95% C.I., 93–100%) and 83% (95% C.I., 71–96%), respectively. Tumors ≤1.5 cm had a better 6-month LC than those >1.5 cm (98% vs. 90%, p = 0.008). New intracranial metastatic disease occurring outside of the treatment volume was observed in 7 patients. Grade ≥3 toxicity occurred in 2 patients (8%). Frameless IM-SRS using a single-isocenter approach for treating multiple intracranial metastases can produce clinical outcomes that compare favorably with those of conventional SRS in a much shorter treatment time (<40 minutes). Given its faster treatment time, this technique is appealing to both patients and personnel in busy clinics.
Publication Year: 2010
Publication Date: 2010-09-01
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
Access and Citation
Cited By Count: 84
AI Researcher Chatbot
Get quick answers to your questions about the article from our AI researcher chatbot