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Journal article
Stereotactic Laser Ablation (SLA) followed by consolidation stereotactic radiosurgery (cSRS) as treatment for brain metastasis that recurred locally after initial radiosurgery (BMRS): a multi-institutional experience
Journal of neuro-oncology, v 156(2), pp 295-306
2022
PMID: 35001245
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The optimal treatment paradigm for brain metastasis that recurs locally after initial radiosurgery remains an area of active investigation. Here, we report outcomes for patients with BMRS treated with stereotactic laser ablation (SLA, also known as laser interstitial thermal therapy, LITT) followed by consolidation radiosurgery.
Clinical outcomes of 20 patients with 21 histologically confirmed BMRS treated with SLA followed by consolidation SRS and > 6 months follow-up were collected retrospectively across three participating institutions.
Consolidation SRS (5 Gy × 5 or 6 Gy × 5) was carried out 16-73 days (median of 26 days) post-SLA in patients with BMRS. There were no new neurological deficits after SLA/cSRS. While 3/21 (14.3%) patients suffered temporary Karnofsky Performance Score (KPS) decline after SLA, no KPS decline was observed after cSRS. There were no 30-day mortalities or wound complications. Two patients required re-admission within 30 days of cSRS (severe headache that resolved with steroid therapy (n = 1) and new onset seizure (n = 1)). With a median follow-up of 228 days (range: 178-1367 days), the local control rate at 6 and 12 months (LC
, LC
) was 100%. All showed diminished FLAIR volume surrounding the SLA/cSRS treated BMRS at the six-month follow-up; none of the patients required steroid for symptoms attributable to these BMRS. These results compare favorably to the available literature for repeat SRS or SLA-only treatment of BMRS.
This multi-institutional experience supports further investigations of SLA/cSRS as a treatment strategy for BMRS.
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Details
- Title
- Stereotactic Laser Ablation (SLA) followed by consolidation stereotactic radiosurgery (cSRS) as treatment for brain metastasis that recurred locally after initial radiosurgery (BMRS): a multi-institutional experience
- Creators
- Isabela Peña Pino - University of MinnesotaJun Ma - University of MinnesotaYusuke S Hori - Cleveland Clinic Lerner College of MedicineElena Fomchenko - Yale Cancer CenterKathryn Dusenbery - University of MinnesotaMargaret Reynolds - University of MinnesotaChristopher Wilke - University of MinnesotaJianling Yuan - University of MinnesotaEthan Srinivasan - Duke University HospitalMatthew Grabowski - Duke University HospitalPeter Fecci - Duke University HospitalEvidio Domingo-Musibay - University of MinnesotaNaomi Fujioka - University of MinnesotaGene H Barnett - Cleveland Clinic Lerner College of MedicineVeronica Chang - Yale Cancer CenterAlireza M Mohammadi - Cleveland Clinic Lerner College of MedicineClark C Chen - University of Minnesota Medical Center
- Publication Details
- Journal of neuro-oncology, v 156(2), pp 295-306
- Publisher
- Springer Nature
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:000740594000001
- Scopus ID
- 2-s2.0-85122676481
- Other Identifier
- 991022004873604721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Oncology