Radiosurgical dose selection for brain metastasis.

摘要: Dose selection for brain metastasis radiosurgery is based largely upon clinical data obtained over a half century of radiosurgical treatments various benign and malignant conditions. It expected that within the entire process, step dose will occur framework accurate calibration delivery detailed imaging planning treatment. Brain should seek lifelong, uncomplicated control. A low not control tumor achieve this therapeutic goal, neither controls but causes symptomatic radiation necrosis. The volume being targeted normal tissues receiving substantial doses are paramount importance in selection. high degree conformality high-dose treatment to has been shown decrease complications, as does steep gradient between adjacent tissue. dose-escalation trial conducted by Radiation Therapy Oncology Group differentially dose-escalated tumors different sizes established single-fraction 15 24 Gy relatively safe patients who have received prior fractionated therapy brain. Corresponding do exist treated with primary no whole therapy. three-fraction metastases at Stanford. Knowledge details, including delivered time interval since was given may affect choice dose, recent administration systemic, radiation-potentiating chemotherapy. Physician knowledge careful judgment, together can minimize risks associated radiosurgery.