Title: Dose Escalation with Fractionated Radiosurgery in Oligometastases Brain with Controlled Extracranial Disease: Improved Progression free Survival Outcome
Authors: Dr Sambit Swarup Nanda, Dr Rohini Khurana, Yoganathan SA, Dr Animesh Agrawal
DOI: http://dx.doi.org/10.18535/jmscr/v4i4.12
Traditionally Whole Brain Radiotherapy (WBRT) has been used in unresectable and oligo/multiple metastases, but the outcomes are not very promising. Here we report eighteen month survival with stable intracranial disease in a case of adenocarcinoma of lung with three metastatic brain lesions after being treated with WBRT with Fractionated Stereotactic Radiosurgery (FSR) boost. 1. Andrews DW, Scott CB, Sperduto PW, Flanders AE et al: Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: Phase III results of the RTOG 9508 randomised trial. Lancet 2004, 363:1665-1672. 2. Sperduto PW, Hall WA et al. The cost-effectiveness for alternative treatments for single brain metastases. In: Kondziolka D, editor. Radiosurgery 1995.Vol 1. Basel: Karger; 1996. p. 180-7. 3. Pirzkall A, Debus J, Lohr F. et al. Radiosurgery alone or in combination with whole-brain radiotherapy for brain metastases. J ClinOncol. 1998;16:3563-3569 4. Sneed PK, Suh JH, Goetsch SJ. et al. A multi-institutional review of radiosurgery alone vs radiosurgery with whole brain radiotherapy as the initial management of brain metastases. Int J RadiatOncolBiol Phys. 2002;53:519-526 5. Sanghavi SN, Miranpuri SS, Chappell R, Buatti JM et al: Radio surgery for patients with brain metastases: A multi-institutional analysis, stratified by the RTOG recursive partitioning analysis method. Int J RadiatOncolBiolPhys 2001, 51:426–434. 6. Kondziolka D, Patel A, Lunsford LD, Kassam A, Flickinger JC: Stereotactic radiosurgery plus whole brain radiotherapy versus radiotherapy alone for patients with multiple brain metastases. Int J Radiat Oncol Biol Phys 1999, 45(2):427-434. 7. Kocher M, Soffietti R, Abacioglu U, Villà S, Fauchon F, Baumert BG, Fariselli L, Tzuk-Shina T, Kortmann RD, Carrie C, Ben Hassel M, Kouri M, Valeinis E, van den Berge D, Collette S, Collette L, Mueller RP: Adjuvant whole brain radiotherapy versus observation after radiosurgery or surgical resection of 1–3 cerebral metastases: Results of the EORTC 22952–26001 study. J Clin Oncol 2011, 29(2):134-141. 8. Sahgal et al. Phase 3 Trials of Stereotactic Radiosurgery With or Without Whole-Brain Radiation Therapy for 1 to 4 Brain Metastases: Individual Patient Data Meta-Analysis. Int J RadiatOncolBiolPhys 2015,91,710-717Abstract
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