Journal Article

DKFZ-2023-01982

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Post-Operative Stereotactic Radiotherapy for Resected Brain Metastases: Results of the Multicenter Analysis (AURORA) of the German Working Group 'Stereotactic Radiotherapy'.

Bernhardt, D.DKFZ* ; Peeken, J. C. ; Kehl, V. ; Eitz, K. ; Guckenberger, M. ; Andratschke, N. ; Mayinger, M. C. ; Lindel, K. ; Dieckmann, K. ; El Shafie, R. ; Debus, J.DKFZ* ; Riesterer, O. ; Rogers, S. ; Blanck, O. ; Wolff, R. ; Grosu, A.DKFZ* ; Bilger, A. ; Henkenberens, C. ; Schulze, K. ; Gani, C. ; Müller, A. C. ; Radlanski, K. ; Janssen, S. ; Ferentinos, K. ; Combs, S. E.

2023
Elsevier Science Amsterdam [u.a.]

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Please use a persistent id in citations: doi:10.1016/j.ijrobp.2023.06.842

Abstract: While the results of prospective studies support the use of postoperative stereotactic radiotherapy (RT) to the resection cavity (RC) as the standard of care after surgery, there are several issues that need to be investigated such as factors for improving local control, risk of leptomeningeal disease and radiation necrosis. Further, the optimal dose and fractionation is still under debate.The working group 'Stereotactic Radiotherapy' of the German Society of Radiation Oncology (DEGRO) analyzed its multi-institutional database with 661 patients who received postoperative stereotactic RT to the RC. Treatment was performed at 13 centers between 2008 and 2021. Patient characteristics, treatment details, and follow-up data including overall survival (OS), local control (LC) were evaluated. Cox Regression and Kaplan-Meier curves with Log-rank Tests were calculated for selected variables.In this retrospective study, overall survival was 61.5% at 1 year, 47.6% at 2 years, and 35.5% at 3 years, and local control was 84.6% at 1 year, 74.8% at 2 years, and 72.8% at 3 years. 96% of patients were treated with hypofractionated stereotactic radiotherapy (HSRT), only 26 patients received single fraction radiosurgery (4%). Prognostic factors associated with overall survival were Karnofsky Performance Status, RPA and GPA class, controlled primary tumor and absence of extracranial metastases, whereas prognostic factor associated with local control was planning target volume (23 mL or less).HSRT is the most common fractionation form in the treatment of RCs in this multicenter analysis. This approach results in excellent OS and LC outcomes. OS in patients with resected brain metastases is mainly influenced by performance status. In regard to local control, RT of large cavities remain a challenge with significantly worse outcome.

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Contributing Institute(s):

1. DKTK Koordinierungsstelle München (MU01)
2. E050 KKE Strahlentherapie (E050)
3. DKTK HD zentral (HD01)
4. DKTK Koordinierungsstelle Freiburg (FR01)

Research Program(s):

1. 315 - Bildgebung und Radioonkologie (POF4-315) (POF4-315)

Appears in the scientific report 2023

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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