Journal of Neuro-Oncology and Neuroscience 开放获取

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Local field radiation therapy after resection of metastatic lesions in a single brain lesion

El-Aziz Ghannam AA, El-Ghany Khedr RA, Ibrahim MF and Ganna AA

Objective: To evaluate the local control-free survival and distant failure-free survival in patients treated with surgical resection and local field radiotherapy.
Background: Local surgical resection of a solitary brain metastasis followed by local fractionated radiotherapy can reduce the irradiation of normal brain tissue, thereby reducing the long-term effects.
Methods: From January 2011 to April 2015, 31 patients with solitary brain metastasis underwent surgical resection combined with involved field radiotherapy; local recurrence (LR)-free survival, distant failure (DF)-free survival, and overall survival (OS) were estimated and correlated with clinical variables. Salvage therapy and toxicity were evaluated.
Results: The median follow-up time for the entire group of patients was 18 months, and the 12-month LR-free survival rate was 89.4%, the DF-free survival rate was 72%, and the overall survival rate was 86.4%. Univariate analysis did not find clinical factors associated with local recurrence; however, univariate analysis showed that the primary tumor and the tentorial relationship were associated with distant failure. RPA classification was associated with overall survival. Four of five patients had salvaged LR, and ten of twelve patients had salvaged DF. Only one case of radiation necrosis was reported.Conclusions
: Surgical resection of a solitary brain metastasis followed by local field radiation therapy has acceptable local control rates and toxicity in carefully selected patients with controlled primary and metastatic disease.