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Optimal hypofractionated conformal radiotherapy for large brain metastases in patients with high risk factors: a single-institutional prospective study

Overview of attention for article published in Radiation Oncology, October 2014
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Title
Optimal hypofractionated conformal radiotherapy for large brain metastases in patients with high risk factors: a single-institutional prospective study
Published in
Radiation Oncology, October 2014
DOI 10.1186/s13014-014-0231-5
Pubmed ID
Authors

Hiroshi K Inoue, Hiro Sato, Yoshiyuki Suzuki, Jun-ichi Saitoh, Shin-ei Noda, Ken-ichi Seto, Kota Torikai, Hideyuki Sakurai, Takashi Nakano

Abstract

BackgroundA single-institutional prospective study of optimal hypofractionated conformal radiotherapy for large brain metastases with high risk factors was performed based on the risk prediction of radiation-related complications.MethodsEighty-eight patients with large brain metastases ¿10 cm3 in critical areas treated from January 2010 to February 2014 using the CyberKnife were evaluated. The optimal dose and number of fractions were determined based on the surrounding brain volume circumscribed with a single dose equivalent (SDE) of 14 Gy (V14) to be less than 7 cm3 for individual lesions. Univariate and multivariate analyses were conducted.ResultsAs a result of optimal treatment, 92 tumors ranging from 10 to 74.6 cm3 (median, 16.2 cm3) in volume were treated with a median prescribed isodose of 57% and a median fraction number of five. In order to compare the results according to the tumor volume, the tumors were divided into the following three groups: 1) 10¿19.9 cm3, 2) 20¿29.9 cm3 and 3) ¿30 cm3. The lesions were treated with a median prescribed isodose of 57%, 56% and 55%, respectively, and the median fraction number was five in all three groups. However, all tumors ¿20 cm3 were treated with¿¿¿five fractions. The median SDE of the maximum dose in the three groups was 47.2 Gy, 48.5 Gy and 46.5 Gy, respectively. Local tumor control was obtained in 90.2% of the patients, and the median survival was nine months, with a median follow-up period of seven months (range, 3-41 months). There were no significant differences in the survival rates among the three groups. Six tumors exhibited marginal recurrence 7-36 months after treatment. Ten patients developed symptomatic brain edema or recurrence of pre-existing edema, seven of whom required osmo-steroid therapy. No patients developed radiation necrosis requiring surgical resection.ConclusionOur findings demonstrate that the administration of optimal hypofractionated conformal radiotherapy based on the dose-volume prediction of complications (risk line for hypofractionation), as well as Kjellberg¿s necrosis risk line used in single-session radiosurgery, is effective and safe for large brain metastases or other lesions in critical areas.

Mendeley readers

The data shown below were compiled from readership statistics for 55 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 2%
Belgium 1 2%
Unknown 53 96%

Demographic breakdown

Readers by professional status Count As %
Researcher 12 22%
Other 10 18%
Student > Postgraduate 6 11%
Student > Master 6 11%
Student > Ph. D. Student 4 7%
Other 10 18%
Unknown 7 13%
Readers by discipline Count As %
Medicine and Dentistry 32 58%
Nursing and Health Professions 3 5%
Engineering 3 5%
Agricultural and Biological Sciences 2 4%
Physics and Astronomy 2 4%
Other 4 7%
Unknown 9 16%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 October 2014.
All research outputs
#6,854,151
of 7,918,051 outputs
Outputs from Radiation Oncology
#965
of 1,066 outputs
Outputs of similar age
#159,259
of 198,038 outputs
Outputs of similar age from Radiation Oncology
#77
of 77 outputs
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