Article
Oncology
Binwei Lin, Dan Huang, Huan Du, Jinjia Fan, Yu Zhang, Gang Feng, Feng Gao, Xiao Bo Du
Summary: This study compared the efficacy of whole-brain radiation therapy (WBRT) with simultaneous integrated boost (SIB) to WBRT followed by stereotactic radiosurgery (SRS) in lung cancer patients with brain metastasis. The results showed that WBRT + SIB provided a longer intracranial progression-free survival and lower incidence of progression outside the radiation field compared to WBRT + SRS, indicating better local control for brain metastasis. However, there was no significant difference in overall survival and toxicity between the two treatment groups.
FRONTIERS IN ONCOLOGY
(2021)
Article
Clinical Neurology
Benjamin J. Rich, Deukwoo Kwon, Yash S. Soni, Jonathan B. Bell, Danny John, Gregory Azzam, Eric A. Mellon, Raphael Yechieli, Jessica Meshman, Matthew C. Abramowitz, Joao Marques, Carolina G. Benjamin, Ricardo J. Komotar, Michael Ivan, Tejan Diwanji
Summary: This study aims to determine the optimal frequency of surveillance imaging for long-term survivors with brain metastases after SRS, and concludes that conducting brain MRI examinations every 4 months, without evidence of CNS recurrence within 1 year, is the most cost-effective approach.
WORLD NEUROSURGERY
(2022)
Article
Oncology
Angela Barillaro, Mara Caroprese, Laura Cella, Anna Viggiano, Francesca Buccelli, Chiara Daponte, Chiara Feoli, Caterina Oliviero, Stefania Clemente, Antonio Farella, Manuel Conson, Roberto Pacelli
Summary: Brain metastases are severe events in patients with solid tumors. Stereotactic radiation therapy is an effective treatment for brain metastases, but it may lead to radiation necrosis, which can impact patient's quality of life. Prompt recognition and treatment are necessary for managing radiation necrosis.
Article
Oncology
Raphael Bodensohn, Anna -Lena Kaempfel, Anne-Laure Boulesteix, Anna Maria Orzelek, Stefanie Corradini, Daniel Felix Fleischmann, Robert Forbrig, Sylvia Garny, Indrawati Hadi, Jan Hofmaier, Giuseppe Minniti, Ulrich Mansmann, Montserrat Pazos Escudero, Niklas Thon, Claus Belka, Maximilian Niyazi
Summary: This prospective nonrandomized controlled trial aimed to compare whole-brain radiotherapy (WBRT) and stereotactic radiosurgery (SRS) in the treatment of multiple brain metastases. Propensity-score matching was performed to compare the efficacy between SRS and historical WBRT control groups. The results showed no significant differences in overall survival and intracranial progression-free survival between the two groups, and no grade III toxicities were observed in the SRS group. The trial did not meet its primary endpoint, and further prospective randomized trials are needed in the era of immunotherapy and targeted therapies.
RADIOTHERAPY AND ONCOLOGY
(2023)
Review
Oncology
Kelly H. Yoo, David J. Park, John H. Choi, Neelan J. Marianayagam, Michael Lim, Antonio Meola, Steven D. Chang
Summary: Solid tumors metastasizing to the brain are a common occurrence, and conventional treatments like surgical resection and whole-brain radiotherapy have limitations in long-term survival and local control outcomes. Stereotactic radiosurgery (SRS) has emerged as an alternative approach to improve control rates, and the use of high-dose radiation has sparked interest in eliciting antitumor immunity. The blood-brain barrier has traditionally posed a challenge to systemic therapy, but recent developments in immunotherapy show promise in managing intracranial metastasis.
FRONTIERS IN ONCOLOGY
(2023)
Article
Oncology
Alejandro Bugarini, Evan Meekins, Joshua Salazar, Andrea L. Berger, Michel Lacroix, Edward A. Monaco III, Andrew R. Conger, Anand Mahadevan
Summary: Neoadjuvant stereotactic radiosurgery (SRS) may reduce the incidence of radionecrosis (RN) and decrease radiation to normal tissue in patients with cerebral metastatic disease. A retrospective analysis of 47 brain metastases patients showed that neoadjuvant SRS was associated with reduced radiotherapy doses, improved conformality profile, and decreased radiation to normal tissue, supporting its use in the treatment of brain metastases.
RADIOTHERAPY AND ONCOLOGY
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Da Hyun Lee, Ji Eun Park, NakYoung Kim, Seo Young Park, Young-Hoon Kim, Young Hyun Cho, Jeong Hoon Kim, Ho Sung Kim
Summary: This study aimed to predict tumor recurrence after SRS of brain metastasis by performing a longitudinal tumor habitat analysis. The results showed that an increased hypovascular cellular habitat was associated with the risk of recurrence and indicative of the recurrence site. Tumor habitat analysis may help guide future treatments for patients with brain metastases.
KOREAN JOURNAL OF RADIOLOGY
(2023)
Article
Biology
Leonie Johannwerner, Elisa M. Werner, Oliver Blanck, Stefan Janssen, Florian Cremers, Nathan Y. Yu, Dirk Rades
Summary: Based on the study, a maximum biologically effective dose (BED) of 45 Gy(12) is recommended for stereotactic radiosurgery (SRS) of brain metastases measuring 21-30 mm. However, for de novo lesions without prior brain irradiation, the tolerable BED may be higher than 45 Gy(12). This study investigated the occurrence of radiation necrosis (RN) after single-fraction SRS or fractionated stereotactic radiotherapy (FSRT) with a BED greater than 49 Gy(12) for radiotherapy-naive brain metastases. The results showed that FSRT with BED > 49 Gy(12) had a lower risk of RN for metastases larger than 20 mm and appeared to be safer than SRS for such lesions.
Review
Radiology, Nuclear Medicine & Medical Imaging
Pyeong Hwa Kim, Chong Hyun Suh, Ho Sung Kim, Kyung Won Kim, Dong Yeong Kim, Ayal A. Aizer, Rifaquat Rahman, Jeffrey P. Guenette, Raymond Y. Huang
Summary: The study compared the incidence of treatment-related necrosis in patients with brain metastases receiving combination SRS+ICI therapy versus SRS therapy alone. Results showed a significantly higher incidence of necrosis in the combination therapy group.
EUROPEAN RADIOLOGY
(2021)
Article
Oncology
Naoyuki Kanayama, Toshiki Ikawa, Shingo Ohira, Takero Hirata, Masahiro Morimoto, Kazuhiko Ogawa, Teruki Teshima, Koji Konishi
Summary: This study demonstrates that a significant reduction in brain metastases volume at 6 months post-SRT can predict local control. The dose of 80% of the gross tumor volume (GTV) D80 in the LQ model: alpha/beta = 20 may be a predictive factor for volume reduction.
Article
Oncology
Yasunori Sato, Masaaki Yamamoto, Toru Serizawa, Kei-ichiro Yamada, Yoshinori Higuchi, Hidetoshi Kasuya
Summary: A grading system for brain metastases patients treated with stereotactic radiosurgery and surviving long has been developed in this study. Through analysis of clinical factors, five factors correlated with survival of more than 3 years were identified and used to categorize patients into four grades, with significant differences in mean survival times among the grades. The model was shown to be useful in predicting survival time for patients undergoing aggressive treatment options.
RADIOTHERAPY AND ONCOLOGY
(2021)
Article
Oncology
Yen-Ling Lai, Jun-Hyeok Kang, Che-Yu Hsu, Jung-Il Lee, Wen-Fang Cheng, Yu-Li Chen, Yoo-Young Lee
Summary: This study found that for EOC patients with CNS metastases, factors such as serous histological type, disease progression, CNS involvement in first disease recurrence, and GKS-based combination treatment significantly impact survival. Patients with CNS involvement not in first tumor recurrence who underwent GKS-based combination treatment showed superior survival.
FRONTIERS IN ONCOLOGY
(2021)
Article
Oncology
Johannes Kerschbaumer, Matthias Demetz, Aleksandrs Krigers, Meinhard Nevinny-Stickel, Claudius Thome, Christian F. Freyschlag
Summary: This study evaluated the risk factors for radiation necrosis in 388 patients who underwent radiosurgery. The results showed that larger tumor diameter and higher radiation dose were reliable independent risk factors leading to more frequent radiation necroses, regardless of tumor type.
Article
Oncology
Xiaotao Dong, Kunlun Wang, Hui Yang, Yan Li, Yanqi Hou, Jiali Chang, Ling Yuan
Summary: A retrospective review compared the efficacy of SRS and WBRT+SIB in NSCLC-BM patients, and found that WBRT+SIB may have better intracranial local control than SRS in the context of systemic drug therapy.
FRONTIERS IN ONCOLOGY
(2023)
Review
Surgery
Hao Deng, Botao Xiong, Yuan Gao, Yang Wu, Wei Wang
Summary: This systematic review and meta-analysis evaluated the effect of combining radiosurgery and immune checkpoint inhibitors in the treatment of brain metastasis. The results showed that combination therapy significantly improved overall survival, local control, and distant brain control compared to radiosurgery alone, but the effect varied for different pathological types.
ASIAN JOURNAL OF SURGERY
(2023)