Radiosurgery or Fractionated Stereotactic Radiotherapy plus Whole-brain Radioherapy in Brain Oligometastases: A Long-term Analysis

Anticancer Res. 2015 May;35(5):3055-9.

Abstract

Aim: To analyze the outcome of patients with brain oligometastases treated by radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT) after whole-brain radiotherapy (WBRT).

Patients and methods: Overall survival (OS) and local control (LC) were evaluated in patients (patients) with 1-2 brain metastases.

Results: Forty-seven patients were selected. They were submitted to WBRT (median dose=3,750 cGy) followed by SRS (17 patients; median dose=1,500 cGy) or FSRT (30 patients; median dose=2,000 cGy). Median follow-up was 102 months (range=17-151); the median survival was 22 months for the SRS group and 16 months for the FSRT group. One-year and 5-year survival was 56% and 16%, respectively, in SRT and 62.1% and 3%, respectively, in FSRT. Neither treatment proved to significantly impact OS (p=0.4). The 1-year LC rates were 80% and 61.1% in the two groups, respectively (p=0.15).

Conclusion: SRS or FSRT after WBRT could offer the same outcomes in patients with brain oligometasteses. Further investigation is warranted to confirm these data and define the optimal stereotactic modality.

Keywords: Brain oligometastases; RPA; fractionation; stereotactic radiotherapy; whole brain radiotherapy.

MeSH terms

  • Adult
  • Aged
  • Brain Neoplasms / radiotherapy*
  • Brain Neoplasms / secondary
  • Dose Fractionation, Radiation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasms / pathology
  • Neoplasms / radiotherapy*
  • Prognosis
  • Radiation Dosage
  • Radiosurgery / methods*
  • Retrospective Studies
  • Survival Analysis