Therapeutic Results of the Treatment Brain Tumors Using Radiosurgery and Stereotactic Radiotherapy

Česká verzia

Authors: H. Doleželová ¹; L. Hynková ¹; P. Pospíšil ¹; T. Kazda ¹; P. Šlampa ¹; I. Čoupková ¹; I. Šiková ²; P. Fardus ³; T. Svoboda ⁴; J. Garčic ⁵; M. Vrzal ⁵; I. Selingerová ⁶; I. Horová ⁶
Authors place of work: Klinika radiační onkologie LF MU a MOÚ Brno ¹; Neurologická ambulance MOÚ Brno ²; Neurochirurgická klinika LF MU a FN Brno ³; Klinika komplexní onkologické péče LF MU a MOÚ Brno ⁴; Oddělení radiologické fyziky MOÚ Brno ⁵; Ústav matematiky a statistiky PřF MU Brno ⁶
Published in the journal: Klin Onkol 2012; 25(6): 445-451
Category: Original Articles

Práce byla podpořena Evropským fondem pro regionální rozvoj a státním rozpočtem České republiky (OP VaVpI – RECAMO, CZ.1.05/2.1.00/03.0101).

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Summary

Background:
We reviewed the results of treatment of patiens treated with stereotactic radiation methods in our department.

Material and methods:
Patients with primary brain tumor or brain metastases underwent CT and MR examination. Then they were treated on X knife in the Clinic of Radiation Oncology in Masaryk Memorial Cancer Institute Brno.

Results:
A total of 101 patients with primary brain tumors underwent stereotactic treatment. These were mainly meningeomas, high-grade gliomas and low-grade gliomas. In 37% of cases patients underwent reiradiation. Stereotactic radiosurgery was applied with a median dose of 18 Gy. Hypofrakcionated stereotactic radiotherapy was applied at a doses of mostly 5 × 5 Gy. Total toxicity of treatment was low: 8% acute G1, late toxicity in 1% of cases. In the whole group achieved partial remission 10 patients (9,9%). One patient had complete remission (0,99%). It was a diagnosis of pituitary adenoma. In 69 patients stable disease was observed (68,3%) and 12 patients had progression (11,88%). Median follow up the entire group was 22,4 months. A statistically significant difference in survival was found in the comparison of different diagnosis, patiens who recieved prior radiotherapy and patiens without previous irradiation. Another significant difference in survival was observed compared to patients treated with stereotactic treatment or stereotactic radiosurgery and the size of the tumor volume larger / smaller 10 cm³. In the group with brain metastases there were 56 patients. In 10% of cases preceded radiotherapy neurosurgical performance. Twenty four patients underwent cranial irradiation entire dose of 30 Gy. Median stereotactic radiosurgery dose was 20 Gy, the application of stereotactic treatment were mostly of 5 × 5 Gy. G1 acute toxicity occurred in 2 patients (3.8%), grade G2 in one patient (1.9%). Late toxicity was observed in 2 patients (one G1 and one G3). Complete remission was achieved in 4 patients (7.1%), partial remission in 27 patients (48.2%), stable disease in 9 (16.1%) and progression was observed in 5 patients (8.9%). Median follow-up the entire group was 13.3 months. There was no statistically significant difference in survival with respect to gender, age, KI, irradiation of the whole brain or type of treatment used. Patients who have undergone neurosurgery prior to irradiation had no difference in survival compared to patients without surgery, but the time to progression was significantly longer (p = 0.016).

Conclusion:
Stereotactic radiation methods are part of modern radiotherapy. Their indication is necessary to consider with regard to the benefit of the patient. Quality equipment radiotherapy department and trained personnel are the condition for their correct using.

Key words:
radiosurgery – brain neoplasms – locoregional neoplasm recurrence – stereotactic radiotherapy

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