Universität zu Köln

Telentschak, Sergej ORCID: 0000-0001-9545-3990, Ruess, Daniel, Grau, Stefan ORCID: 0000-0002-9742-527X, Goldbrunner, Roland, von Spreckelsen, Niklas ORCID: 0000-0002-9873-1711, Jablonska, Karolina, Treuer, Harald, Kocher, Martin and Ruge, Maximilian (2021). Cyberknife(R) hypofractionated stereotactic radiosurgery (CK-hSRS) as salvage treatment for brain metastases. J. Cancer Res. Clin. Oncol., 147 (9). S. 2765 - 2774. NEW YORK: SPRINGER. ISSN 1432-1335

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Abstract

Purpose The introduction of hypofractionated stereotactic radiosurgery (hSRS) extended the treatment modalities beyond the well-established single-fraction stereotactic radiosurgery and fractionated radiotherapy. Here, we report the efficacy and side effects of hSRS using Cyberknife(R) (CK-hSRS) for the treatment of patients with critical brain metastases (BM) and a very poor prognosis. We discuss our experience in light of current literature. Methods All patients who underwent CK-hSRS over 3 years were retrospectively included. We applied a surface dose of 27 Gy in 3 fractions. Rates of local control (LC), systemic progression-free survival (PFS), and overall survival (OS) were estimated using Kaplan-Meier method. Treatment-related complications were rated using the Common Terminology Criteria for Adverse Events (CTCAE). Results We analyzed 34 patients with 75 BM. 53% of the patients had a large tumor, tumor location was eloquent in 32%, and deep seated in 15%. 36% of tumors were recurrent after previous irradiation. The median Karnofsky Performance Status was 65%. The actuarial rates of LC at 3, 6, and 12 months were 98%, 98%, and 78.6%, respectively. Three, 6, and 12 months PFS was 38%, 32%, and 15%, and OS was 65%, 47%, and 28%, respectively. Median OS was significantly associated with higher KPS, which was the only significant factor for survival. Complications CTCAE grade 1-3 were observed in 12%. Conclusion Our radiation schedule showed a reasonable treatment effectiveness and tolerance. Representing an optimal salvage treatment for critical BM in patients with a very poor prognosis and clinical performance state, CK-hSRS may close the gap between surgery, stereotactic radiosurgery, conventional radiotherapy, and palliative care.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Telentschak, Sergej UNSPECIFIED orcid.org/0000-0001-9545-3990 UNSPECIFIED Ruess, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Grau, Stefan UNSPECIFIED orcid.org/0000-0002-9742-527X UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED von Spreckelsen, Niklas UNSPECIFIED orcid.org/0000-0002-9873-1711 UNSPECIFIED Jablonska, Karolina UNSPECIFIED UNSPECIFIED UNSPECIFIED Treuer, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Kocher, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruge, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-564980
DOI:	10.1007/s00432-021-03564-z
Journal or Publication Title:	J. Cancer Res. Clin. Oncol.
Volume:	147
Number:	9
Page Range:	S. 2765 - 2774
Date:	2021
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-1335
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/56498