Reirradiation of brain metastases with radiosurgery.

摘要: Abstract Purpose To assess the outcome of reirradiation with stereotactic radiosurgery (SRS) brain metastases (BM) recurring after whole radiotherapy (WBRT). Methods and materials Between September 2001 October 2008, 69 patients who recurred WBRT were re-irradiated SRS using a linear accelerator. The dose prescription was generally chosen according to maximum diameter tumor as suggested by Radiation Therapy Oncology Group (RTOG) 90-05 protocol. Patients stratified Karnofsky Performance Status (KPS), Neurologic Functional Score (NFS), RTOG Recursive Partitioning Analysis (RPA), Index for Radiosurgery (SIR), primary disease, dimension number BM, time first recurrence WBRT. Response, survival, toxicity analyzed. Results At this retrospective analysis all had died. reirradiated 150 metastases. Median interval between prior 11 months median prescribed 20 Gy. Response obtained in 91% lesions 1-year local control rate 74 ± 4%. Significantly longer duration response associated higher doses (⩾23 Gy) achieved (complete partial better than stable disease). Cause death failure only 36 (52%) patients. overall survival 10 months. Variables which significantly conditioned KPS NFS. Four (6%) asymptomatic radionecrosis that developed prevalently when lesion diameters larger cumulative exceeded values recommended About three-fourth good NFS reirradiation. Conclusions Reirradiation BM resulted feasible effective. A correct patient selection an accurate evaluation irradiation suggested.