Telentschak, Sergej ORCID: 0000-0001-9545-3990, Ruess, Daniel, Grau, Stefan ORCID: 0000-0002-9742-527X, Goldbrunner, Roland, von Spreckelsen, Niklas ORCID: 0000-0002-9873-1711, Jablonska, Karolina, Treuer, Harald, Kocher, Martin and Ruge, Maximilian (2021). Cyberknife(R) hypofractionated stereotactic radiosurgery (CK-hSRS) as salvage treatment for brain metastases. J. Cancer Res. Clin. Oncol., 147 (9). S. 2765 - 2774. NEW YORK: SPRINGER. ISSN 1432-1335

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Abstract

Purpose The introduction of hypofractionated stereotactic radiosurgery (hSRS) extended the treatment modalities beyond the well-established single-fraction stereotactic radiosurgery and fractionated radiotherapy. Here, we report the efficacy and side effects of hSRS using Cyberknife(R) (CK-hSRS) for the treatment of patients with critical brain metastases (BM) and a very poor prognosis. We discuss our experience in light of current literature. Methods All patients who underwent CK-hSRS over 3 years were retrospectively included. We applied a surface dose of 27 Gy in 3 fractions. Rates of local control (LC), systemic progression-free survival (PFS), and overall survival (OS) were estimated using Kaplan-Meier method. Treatment-related complications were rated using the Common Terminology Criteria for Adverse Events (CTCAE). Results We analyzed 34 patients with 75 BM. 53% of the patients had a large tumor, tumor location was eloquent in 32%, and deep seated in 15%. 36% of tumors were recurrent after previous irradiation. The median Karnofsky Performance Status was 65%. The actuarial rates of LC at 3, 6, and 12 months were 98%, 98%, and 78.6%, respectively. Three, 6, and 12 months PFS was 38%, 32%, and 15%, and OS was 65%, 47%, and 28%, respectively. Median OS was significantly associated with higher KPS, which was the only significant factor for survival. Complications CTCAE grade 1-3 were observed in 12%. Conclusion Our radiation schedule showed a reasonable treatment effectiveness and tolerance. Representing an optimal salvage treatment for critical BM in patients with a very poor prognosis and clinical performance state, CK-hSRS may close the gap between surgery, stereotactic radiosurgery, conventional radiotherapy, and palliative care.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Telentschak, SergejUNSPECIFIEDorcid.org/0000-0001-9545-3990UNSPECIFIED
Ruess, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grau, StefanUNSPECIFIEDorcid.org/0000-0002-9742-527XUNSPECIFIED
Goldbrunner, RolandUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
von Spreckelsen, NiklasUNSPECIFIEDorcid.org/0000-0002-9873-1711UNSPECIFIED
Jablonska, KarolinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Treuer, HaraldUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kocher, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruge, MaximilianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-564980
DOI: 10.1007/s00432-021-03564-z
Journal or Publication Title: J. Cancer Res. Clin. Oncol.
Volume: 147
Number: 9
Page Range: S. 2765 - 2774
Date: 2021
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1432-1335
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
OncologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/56498

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