This article is more than 5 years old. Information may no longer be current.
Early metastatic volume decrease after stereotactic radiosurgery linked to prolonged local control
Click Here to Manage Email Alerts
Volume reductions in brain metastases observed at 6 or 12 weeks after stereotactic radiosurgery are predictive of controlled local progression and reduced need for corticosteroid treatment, according to results of a retrospective study.
Researchers assessed 52 patients with 100 metastatic lesions treated with CyberKnife (Accuray Inc.) stereotactic radiosurgery (SRS) at North Carolina Cancer Hospital. All study participants had primary malignancy confirmed by biopsy and an MRI-confirmed diagnosis of brain metastasis.
Eligibility criteria included at least one clinical and radiological follow-up, initial tumor volume of at least 0.1 cm3 and a Karnofsky performance score ≥60. Patients with prior focal radiation or recent whole-brain radiation therapy were excluded from the study. The patients had a median of two (range, 1-8) metastatic lesions. Median follow-up was 15.6 months (range, 2-33 months).
When researchers evaluated SRS-treated metastases that achieved significant volume reduction by 6 or 12 weeks post-SRS, they found no local progression for the remainder of the study period. Moreover, patients whose metastatic lesions did not see a volume decrease at 6 or 12 weeks were more likely to need corticosteroids (P=.01) and exhibit progression in neurological symptoms (P=.003).
Matthew G. Ewend
“We measured the volume of the tumors over time to see if we could predict, based on what happened in the beginning, what would happen long term,” Matthew G. Ewend, MD, chair of the UNC department of neurosurgery and member of the UNC Lineberger Comprehensive Cancer Center, said in a press release. “Tumors that did not shrink in the beginning were more likely later to be correlated to a patient having a neurological problem or needing steroids. If they did shrink, they were more likely to stay under control long term.”
Disclosure: One of the researchers is a stockholder in the St. Louis CyberKnife Center and a consultant for Radiosurgery Center Corp.
Click Here to Manage Email Alerts