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Int J Mol Sci. 2014 Apr 22;15(4):6910-24. doi: 10.3390/ijms15046910.

Treatment of single or multiple brain metastases by hypofractionated stereotactic radiotherapy using helical tomotherapy.

Author information

1
Radiation Therapy Center, Fukui Saiseikai Hospital, 7-1, Funabashi, Wadanaka-cho, Fukui 918-8503, Japan. love_child317@hotmail.com.
2
Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan. yshiba@med.nagoya-cu.ac.jp.
3
Radiation Therapy Center, Fukui Saiseikai Hospital, 7-1, Funabashi, Wadanaka-cho, Fukui 918-8503, Japan. mas-yoshida@fukui.saiseikai.or.jp.
4
Department of Neurosurgery, Fukui Saiseikai Hospital, 7-1, Funabashi, Wadanaka-cho, Fukui 918-8503, Japan. k-wakamatsu@fukui.saiseikai.or.jp.
5
Radiation Therapy Center, Fukui Saiseikai Hospital, 7-1, Funabashi, Wadanaka-cho, Fukui 918-8503, Japan. y-kikuchi@fukui.saiseikai.or.jp.

Abstract

This study investigated the clinical outcomes of a 4-fraction stereotactic radiotherapy (SRT) study using helical tomotherapy for brain metastases. Between August 2009 and June 2013, 54 patients with a total of 128 brain metastases underwent SRT using tomotherapy. A total dose of 28 or 28.8 Gy at 80% isodose was administered in 4 fractions for all tumors. The mean gross tumor volume (GTV) was 1.9 cc. Local control (LC) rates at 6, 12, and 18 months were 96%, 91%, and 88%, respectively. The 12-month LC rates for tumors with GTV ≤0.25, >0.25 and ≤1, and >1 cc were 98%, 82%, and 93%, respectively; the rates were 92% for tumors >3 cc and 100% for >10 cc. The 6-month rates for freedom from distant brain failure were 57%, 71%, and 55% for patients with 1, 2, and >3 brain metastases, respectively. No differences were significant. No major complications were observed. The 4-fraction SRT protocol provided excellent tumor control with minimal toxicity. Distant brain failure was not so frequent, even in patients with multiple tumors. The results of the current study warrant a prospective randomized study comparing single-fraction stereotactic radiosurgery (SRS) with SRT in this patient population.

PMID:
24758932
PMCID:
PMC4013669
DOI:
10.3390/ijms15046910
[Indexed for MEDLINE]
Free PMC Article
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