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Posted by on Sep 17, 2022 in Lung cancer | 0 comments

In a nutshell

This study investigated the effectiveness and safety of fractionated stereotactic radiation therapy (FSRT) for patients with small and moderate-sized brain metastases (BM). The data showed that FSRT was safe and effective in patients with BM of any size with excellent local control.

Some background

Stereotactic radiosurgery (SRS) is commonly used in patients with BM. SRS can directly target the tumor only in the brain, rather than targeting the whole brain. SRS uses high-energy radiation to kill cancer cells by damaging their DNA. SRS is delivered in a single fraction and is useful for small intact BM.

FSRT is an option for treating larger BM (greater than 2 cm). FSRT uses higher doses of radiation in a shorter period of time and targets a specific area from different angles. However, whether FSRT is an effective and safe option for small and moderate-sized BM is still unknown.

Methods & findings

This study involved 60 patients with 133 BM from lung cancer or melanoma. Patients were treated with FSRT. Patients were given an average total dose of 18-32.5 Gy in 3-5 daily fractions. The average follow-up time for a brain MRI was 9.8 months.

Most treated lesions were radiosensitive (70.1%) and larger than 1 cm in size (84.2%). 88% of the patients did not have a previous surgical resection. 17.8% of all patients experienced local failure (reappearance of the cancer in and around the original site of the disease) after 12 months and 32.4% experienced local failure after 24 months.

After 12 months, the risk of local failure was 22.1% for large lesions (more than 1 cm) and 13.7% for small lesions (less than or equal to 1 cm). This difference was not statistically significant.

After 12 months, the risk of radionecrosis (death of cancer cells due to radiation) was 7.1% at 1 year and 13.2% at 2 years.  The average overall survival for all patients was 20.5 months.

The bottom line

This study concluded that FSRT was safe and effective in patients with BM of any size with excellent local control.

The fine print

The study looked back in time at medical records. The sample size was very small. This study only included patients treated at a single institution in Canada.

Published By :

Frontiers in oncology

Date :

Apr 22, 2022

Original Title :

Outcomes of Hypofractionated Stereotactic Radiotherapy for Small and Moderate-Sized Brain Metastases: A Single-Institution Analysis.

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