Three-fraction CyberKnife radiotherapy for brain metastases in critical areas: referring to the risk evaluating radiation necrosis and the surrounding brain volumes circumscribed with a single dose equivalence of 14 Gy (V14).
Three-fraction CyberKnife radiotherapy for brain metastases in critical areas: referring to the risk evaluating radiation necrosis and the surrounding brain volumes circumscribed with a single dose equivalence of 14 Gy (V14).
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DOI：
10.1093/jrr/rrt006
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发表时间：
2013-07-01
影响因子：
2
通讯作者：
Nakano T
中科院分区：
文献类型：
--
作者：
Inoue HK;Seto K;Nozaki A;Torikai K;Suzuki Y;Saitoh J;Noda SE;Nakano T
评价三段式射波刀放射治疗脑关键部位转移患者的疗效和毒性。145例肿瘤bbb10 cm3的159例转移患者接受三段式射波刀放射治疗，中位边际剂量为27 Gy，中位处方等剂量为60%。观察治疗后神经系统表现、局部肿瘤控制及不良反应的变化。以23.1 Gy （14 Gy: V14单剂量当量）为边界测量周围脑体积，评估不良反应的风险。97例患者中有26例（26.8%）神经系统症状得到改善，如运动无力、视觉障碍和失语。在中位随访7个月期间，143例转移患者中有137例（95.8%）获得局部肿瘤控制。9例患者出现症状性水肿，其中3例（2.1%）因放射性坏死需要手术切除。V14为4.6 ~ 31.5 cm3。V14≥7cm3的病灶35例，其中3例因放射性坏死而出现大面积脑水肿。V14 <7 cm3的患者均未出现需要手术的水肿。因此，我们得出结论，三段式射波刀放射治疗关键部位转移获得高局部肿瘤控制率和低并发症发生率。因此，周围脑的V14似乎是评估较大转移灶患者放射性坏死风险的有用指标。
The efficacy and toxicity of three-fraction CyberKnife radiotherapy were evaluated in patients with brain metastases in critical areas. One hundred and fifty-nine metastases in 145 patients including tumors >10 cm3 were treated with three-fraction CyberKnife radiotherapy with a median marginal dose of 27 Gy at a median prescribed isodose of 60%. Changes in the neurological manifestations, local tumor control and adverse effects were investigated after treatment. The surrounding brain volumes circumscribed with 23.1 Gy (single dose equivalence of 14 Gy: V14) were measured to evaluate the risk of adverse effects. Neurological manifestations, such as motor weakness, visual disturbances and aphasia improved in 26 of 97 patients (26.8%). Local tumor control was obtained in 137 of 143 metastases (95.8%) during a median follow-up of 7 months. Nine patients had symptomatic edema and three of them (2.1%) required surgical resection because of radiation necrosis. The V14 of these patients was 4.6–31.5 cm3. There were 35 lesions with a V14 of 7 cm3 or more and three of them developed extensive brain edema due to radiation necrosis. None of the patients with a V14 of <7 cm3 exhibited edema requiring an operation. We therefore conclude that a high rate of local tumor control and low rates of complications are obtained after three-fraction CyberKnife radiotherapy for metastases in critical areas. The V14 of the surrounding brain therefore seems to be a useful indicator for the risk evaluation of radiation necrosis in patients with larger metastases.
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影响因子：
4.8
作者：
Friedman, WA;Bova, FJ;Bradshaw, P
通讯作者：
Bradshaw, P
DOI：
10.1016/s0360-3016(96)00619-0
发表时间：
1997-03-01
影响因子：
7
作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
3.1
作者：
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通讯作者：
Hamm, Klaus
DOI：
10.1016/j.ijrobp.2011.05.034
发表时间：
2011-12-01
影响因子：
7
作者：
Otsuka, Shinya;Shibamoto, Yuta;Ogino, Hiroyuki
通讯作者：
Ogino, Hiroyuki