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Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/3740

Title: Linac-Based Fractionated Stereotactic Radiotherapy with a Micro-Multileaf Collimator for Brainstem Metastasis.
Other Titles: 脳幹部転移性脳腫瘍に対する寡分割定位放射線治療の治療成績
Authors: Sugimoto, Tadashi
Matsuda, Ryosuke
Tamamoto, Tetsuro
Hontsu, Shigeto
Yamaki, Kaori
Miura, Sachiko
Park, Young-Su
Nakase, Hiroyuki
Hasegawa, Masatoshi
Keywords: Brainstem metastasis
Fractionated radiotherapy
Stereotactic radiotherapy
Issue Date: Dec-2019
Publisher: Elsevier
Citation: World neurosurgery Vol.132 p.e680-e686 (2019 Dec)
Abstract: Background: To assess the neuroimaging and clinical outcomes in patients with brainstem metastasis (BSM) treated with linac-based fractionated stereotactic radiotherapy (fSRT) with a micro-multileaf collimator. Methods: Between May 2007 and January 2017, 24 patients (15 male and 9 female) with BSM (25 lesions: midbrain, 10; pons, 13; and medulla oblongata, 2) were consecutively treated with linac-based fSRT. BSM originated from the lung (n = 18, 75.0%), colon (n = 3, 12.5%), and breast (n = 3, 12.5%). The median patient age was 67.0 (range: 42-80) years. Recursive partition analysis classified 2 patients as class I, 17 as class II, and 5 as class III. Overall survival was calculated using the Kaplan-Meier method. Results: Tumor volume ranged from 0.01 to 7.49 cm3 (median: 0.233 cm3), and patients were treated with a dose of 24-40 Gy in 7-13 fractions. The median OS was 9 months after fSRT (95% confidence interval 4.104-13.896). Large tumor volume, presence of brainstem-related symptoms, poor pretreatment Karnofsky performance status, and recursive partition analysis class III were significantly associated with low overall survival. Tumor volume decreased in 18 metastatic lesions, remained stable in 6, and increased in 1. No patient exhibited permanent radiation injury. Grade 2 nausea and vomiting according to the Common Terminology Criteria for Adverse Events 4.0 occurred in 1 patient who received corticosteroids. Conclusions: Linac-based fSRT with a micro-multileaf collimator delivered in the doses of 24-40 Gy in 7-13 fractions is a safe and effective local therapy for patients with BSM.
Description: 博士(医学)・乙第1450号・令和2年3月16日
Copyright © 2019 Elsevier Inc. All rights reserved.
URI: http://hdl.handle.net/10564/3740
ISSN: 18788750
DOI: https://doi.org/10.1016/j.wneu.2019.08.049
Academic Degrees and number: 24601B1450
Degree-granting date: 2020-03-16
Degree name: 博士(医学)
Degree-granting institutions: 奈良県立医科大学
Appears in Collections:2019年度

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