TY  - JOUR
AU  - Diehl, Christian D
AU  - Giordano, Frank A
AU  - Grosu, Anca-L
AU  - Ille, Sebastian
AU  - Kahl, Klaus-Henning
AU  - Onken, Julia
AU  - Rieken, Stefan
AU  - Sarria, Gustavo R
AU  - Shiban, Ehab
AU  - Wagner, Arthur
AU  - Beck, Jürgen
AU  - Brehmer, Stefanie
AU  - Ganslandt, Oliver
AU  - Hamed, Motaz
AU  - Meyer, Bernhard
AU  - Münter, Marc
AU  - Raabe, Andreas
AU  - Rohde, Veit
AU  - Schaller, Karl
AU  - Schilling, Daniela
AU  - Schneider, Matthias
AU  - Sperk, Elena
AU  - Thomé, Claudius
AU  - Vajkoczy, Peter
AU  - Vatter, Hartmut
AU  - Combs, Stephanie E
TI  - Opportunities and Alternatives of Modern Radiation Oncology and Surgery for the Management of Resectable Brain Metastases.
JO  - Cancers
VL  - 15
IS  - 14
SN  - 2072-6694
CY  - Basel
PB  - MDPI
M1  - DKFZ-2023-01543
SP  - 3670
PY  - 2023
AB  - Postsurgical radiotherapy (RT) has been early proven to prevent local tumor recurrence, initially performed with whole brain RT (WBRT). Subsequent to disadvantageous cognitive sequalae for the patient and the broad distribution of modern linear accelerators, focal irradiation of the tumor has omitted WBRT in most cases. In many studies, the effectiveness of local RT of the resection cavity, either as single-fraction stereotactic radiosurgery (SRS) or hypo-fractionated stereotactic RT (hFSRT), has been demonstrated to be effective and safe. However, whereas prospective high-level incidence is still lacking on which dose and fractionation scheme is the best choice for the patient, further ablative techniques have come into play. Neoadjuvant SRS (N-SRS) prior to resection combines straightforward target delineation with an accelerated post-surgical phase, allowing an earlier start of systemic treatment or rehabilitation as indicated. In addition, low-energy intraoperative RT (IORT) on the surgical bed has been introduced as another alternative to external beam RT, offering sterilization of the cavity surface with steep dose gradients towards the healthy brain. This consensus paper summarizes current local treatment strategies for resectable brain metastases regarding available data and patient-centered decision-making.
KW  - brain metastases (Other)
KW  - intraoperative radiation therapy (Other)
KW  - microsurgical resection (Other)
KW  - neurosurgery (Other)
KW  - radiosurgery (Other)
KW  - stereotactic radiation therapy (Other)
KW  - whole brain radiation therapy (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:37509330
C2  - pmc:PMC10377800
DO  - DOI:10.3390/cancers15143670
UR  - https://inrepo02.dkfz.de/record/277875
ER  -