Journal article
A Comparison of Single Fraction and Multi Fraction Radiosurgery on the Gamma Knife ICON: A Single Institution Review
Advances in radiation oncology, v 8(2), 101161
01 Mar 2023
PMID: 36845616
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose: Brain metastases are a common development in patients with malignant solid tumors. Stereotactic radiosurgery (SRS) has a long track record of effectively and safely treating these patients, with some limitations to the use of single fraction SRS based on size and volume. In this study, we reviewed outcomes of patients treated using SRS and fractionated SRS (fSRS) to compare predictors and outcomes of those treatments.Methods and Materials: Two hundred patients treated with SRS or fSRS for intact brain metastases were included. We tabulated baseline characteristics and performed a logistic regression to identify predictors of fSRS. Cox regression was used to identify predictors of survival. Kaplan-Meier analysis was used to calculate survival, local failure, and distant failure rates. A receiver operating characteristic curve was generated to determine timepoint from planning to treatment associated with local failure.Results: The only predictor of fSRS was tumor volume >2.061 cm3. There was no difference in local failure, toxicity, or survival by fractionation of biologically effective dose. Predictors of worse survival were age, extracranial disease, history of whole brain radiation therapy, and volume. Receiver operating characteristic analysis identified 10 days as potential factor in local failure. At 1 year, local control was 96.48 and 76.92% for those patients treated before or after that interval, respectively (P = .0005).Conclusions: Fractionated SRS is a safe and effective alternative for patients with larger volume tumors not suitable for single fraction SRS. Care should be taken to treat these patients expeditiously as a delay was shown to affect local control in this study.& COPY; 2023 The Authors. Published by Elsevier Inc. on behalf of American Society for Radiation Oncology. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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Details
- Title
- A Comparison of Single Fraction and Multi Fraction Radiosurgery on the Gamma Knife ICON: A Single Institution Review
- Creators
- Joseph P. Loftus - Allegheny Hlth Network Canc Inst, Div Radiat Oncol, Monroeville, PA 15146 USAMatthew Shepard - Drexel University, NeurologyYun Liang - Drexel University, Radiation Oncology (and Nuclear Medicine)Alexander Yu - Drexel University, NeurosurgeryStephen M. Karlovits - Allegheny General HospitalRodney E. Wegner (Corresponding Author) - Allegheny Health Network
- Publication Details
- Advances in radiation oncology, v 8(2), 101161
- Publisher
- Elsevier
- Number of pages
- 9
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine); Neurology; Neurosurgery
- Web of Science ID
- WOS:001029178200001
- Scopus ID
- 2-s2.0-85146306209
- Other Identifier
- 991022155292304721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging