Linac-based radiosurgery or fractionated stereotactic radiotherapy with flattening filter-free volumetric modulated arc therapy in elderly patients: Amono-institutional experience on 110 brain metastases

Gregucci, Fabiana; Fiorentino, Alba; Corradini, Stefanie; Figlia, Vanessa; Mazzola, Rosario; Ricchetti, Francesco; Ruggieri, Ruggero und Alongi, Filippo (2019): Linac-based radiosurgery or fractionated stereotactic radiotherapy with flattening filter-free volumetric modulated arc therapy in elderly patients: Amono-institutional experience on 110 brain metastases. In: Strahlentherapie und Onkologie, Bd. 195, Nr. 3: S. 218-225

Abstract

AimThe aim of this study was to analyze the feasibility and clinical results of linear accelerator (linac-)based stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (SFRT) with flattening filter-free (FFF) volumetric modulated arc therapy (VMAT) in elderly patients affected by brain metastases (BMs).Patients and methodsPatients selected for the present analysis were 65years old with alife expectancy of >3months, acontrolled or synchronous primary tumor, and <10BMs with adiameter <3cm. All patients were treated with FFF linac-based SRS/SFRT. The prescribed total dose (15-30Gy/1-5fractions) was based on BM size and proximity to organs at risk (OAR). Toxicity was assessed according to the Common Terminology Criteria for Adverse Events (CTCAE) v4.0. MedCalc v18.2 (MedCalc Software, Ostend, Belgium) was used for statistical analysis.ResultsFrom April 2014 to December 2017, 40elderly patients with 110 BMs were treated by FFF linac-based SRS/SFRT. With amedian follow-up of 28months (range 6-50months), median and 1-year overall survival were 9months and 39%, respectively;median intracranial progression-free survival was 6months. At the time of the analysis, local control was reported in 109/110 BMs (99.1%): 12BMs had acomplete response;51 apartial response;46 showed stable disease. One BM (0.9%) progressed after 2months. BM volume (<1cc) and higher SRS/SFRT dose correlated to treatment response (p=0.01 and p=0.0017, respectively). No adverse events higher than grade2 were observed.ConclusionThe present findings highlight the feasibility, safety, and effectiveness of FFF linac-based SRS/SFRT in elderly patients with BMs.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0179-7158
• Sprache: Englisch