Risk of radiation necrosis after hypofractionated stereotactic radiotherapy (HFSRT) for brain metastases: a single cente
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CLINICAL STUDY
Risk of radiation necrosis after hypofractionated stereotactic radiotherapy (HFSRT) for brain metastases: a single center retrospective study Dario Di Perri1 · Ronan Tanguy1 · Claude Malet1 · Annie Robert2 · Marie‑Pierre Sunyach1 Received: 7 June 2020 / Accepted: 18 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction While hypofractionated stereotactic radiotherapy (HFSRT) is being increasingly used for treating brain metastases, clinical data concerning the incidence and risk factors of its main side-effect, namely radiation necrosis (RN), remain limited. In this context, we assessed risk factors of RN in a single center series of patients with brain metastases treated with three common HFSRT dose regimens: 27 Gy in 3 fractions (27 Gy/3#), 30 Gy in 5 fractions (30 Gy/5#), and 35 Gy in 5 fractions (35 Gy/5#). Methods In total, 360 HFSRT treatments in 294 consecutive patients were retrospectively analysed. Univariable analysis (UVA) and multivariable analysis (MVA) were performed to evaluate the relationship between clinical and dosimetric factors and RN risk. Results The 12-month RN rate was 8.8%. On MVA, risk was higher in lesions receiving 27 Gy/3# (HR 3.07 95%CI [1.13;8.36], p = 0.03) and 35 Gy/5# (HR 4.22 95%CI [1.46,12.21], p 2 cm) brain metastases: a comparative analysis of local control and risk of radiation-induced brain necrosis. Int J Radiat Oncol Biol Phys 95(4):1142–1148 Ernst-Stecken A, Ganslandt O, Lambrecht U et al (2006) Phase II trial of hypofractionated stereotactic radiotherapy for brain metastases: results and toxicity. Radiother Oncol 81(1):18–24 Dore M, Martin S, Delpon G et al (2017) Stereotactic radiotherapy following surgery for brain metastasis: predictive factors for local control and radionecrosis. Cancer Radiother 21(1):4–9 Martinage G, Geffrelot J, Stefan D et al (2019) Efficacy and tolerance of post-operative hypo-fractionated stereotactic radiotherapy in a large series of patients with brain metastases. Front Oncol 9:184 Faruqi S, Ruschin M, Soliman H et al (2020) Adverse radiation effect after hypofractionated stereotactic radiosurgery in 5 daily
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