Post-operative radiation therapy to the surgical cavity with standard fractionation in patients with brain metastases

James D Byrne; Thomas Botticello; Andrzej Niemierko; Helen A Shih; Jay S Loeffler; Kevin S Oh

doi:10.1038/s41598-020-63158-6

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$Post-operative radiation therapy to the surgical cavity with standard fractionation in patients with brain metastases$

Journal article

Open access

Peer reviewed

Post-operative radiation therapy to the surgical cavity with standard fractionation in patients with brain metastases

James D Byrne, Thomas Botticello, Andrzej Niemierko, Helen A Shih, Jay S Loeffler and Kevin S Oh

Scientific reports, Vol.10(1), pp.6331-6331

04/14/2020

DOI: 10.1038/s41598-020-63158-6

PMCID: PMC7156661

PMID: 32286375

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Published (Version of record) Open Access

Abstract

The paradigm for post-operative cavity radiation therapy has shifted to more targeted, less morbid approaches. Single-fraction or hypofractionated radiation therapy is a common approach to treating the postoperative cavity but is associated with a local failure rate 20-40%. We employed an alternative treatment strategy involving fractionated partial brain radiation therapy to the surgical cavity. Patients with brain metastases who underwent radiation treatment 30-42 Gy in 3 Gy/fraction regimens to surgical cavity were retrospectively identified. The 6-month and 12-month freedom from local failure rates were 97.0% and 88.2%. Three patients (7%) experienced local failure at 4, 6, and 22 months. Of these, the histologies were colorectal adenocarcinoma (N = 1) and breast adenocarcinoma (N = 2). The 6-month and 12-month freedom from distant brain metastases rates were 74.1% and 68.8%, respectively, and the 6-month and 12-month overall survival rates were 84.9% and 64.3% respectively. The median overall survival was 39 months, and there were no events of late radionecrosis. Fractionated partial brain irradiation to the surgical cavity of resected brain metastases results in low rates of local failure. This strategy represents an alternative to SRS and WBRT.

Adenocarcinoma - pathology

Adenocarcinoma - surgery

Adult

Aged

Aged, 80 and over

Brain Neoplasms - radiotherapy

Brain Neoplasms - secondary

Breast Neoplasms - pathology

Breast Neoplasms - surgery

Colorectal Neoplasms - pathology

Colorectal Neoplasms - surgery

Dose Fractionation, Radiation

Female

Humans

Male

Middle Aged

Postoperative Period

Survival Analysis

Details

Title: Subtitle: Post-operative radiation therapy to the surgical cavity with standard fractionation in patients with brain metastases
Creators: James D Byrne - Harvard University
Thomas Botticello - Harvard University
Andrzej Niemierko - Harvard University
Helen A Shih - Harvard University
Jay S Loeffler - Harvard University
Kevin S Oh - Massachusetts General Hospital
Resource Type: Journal article
Publication Details: Scientific reports, Vol.10(1), pp.6331-6331
DOI: 10.1038/s41598-020-63158-6
PMID: 32286375
PMCID: PMC7156661
NLM abbreviation: Sci Rep
ISSN: 2045-2322
eISSN: 2045-2322
Language: English
Date published: 04/14/2020
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiation Oncology
Record Identifier: 9984274756202771

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