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Article: Frameless stereotactic radiosurgery for brain metastases: a review of outcomes and prognostic scores evaluation

TitleFrameless stereotactic radiosurgery for brain metastases: a review of outcomes and prognostic scores evaluation
Authors
Issue Date2017
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/
Citation
Hong Kong Medical Journal, 2017, v. 23 n. 6, p. 599–608 How to Cite?
AbstractIntroduction: Stereotactic brain radiosurgery provides good local control in patients with limited brain metastases. A newly developed frameless system allows pain-free treatment. We reviewed the effectiveness of this frameless stereotactic brain radiosurgery and identified prognostic factors that may aid better patient selection. Methods: Medical records of patients with brain metastases treated with linear accelerator–based frameless stereotactic brain radiosurgery between January 2010 and July 2015 in a university affiliated hospital in Hong Kong were reviewed. Outcomes including local and distant brain control rate, progression-free survival, and overall survival were analysed. Prognostic factors were identified by univariable and multivariable analyses. Association of outcomes with four common prognostic scores was performed. Results: In this study, 64 patients with 94 lesions were treated with a median dose of 18 Gy (range, 12-22 Gy) in a single fraction. The median follow-up was 11.5 months. One-year actuarial local and distant brain control rates were 72% and 71%, respectively. The median overall survival was 13.0 months. On multivariable analysis, Karnofsky performance status score (>50 vs ≤50) and number of lesions (1-2 vs ≥3) were found to associate significantly with distinct brain progression-free survival (P=0.022, hazard ratio=0.20, 95% confidence interval 0.05-0.80 and P=0.003, hazard ratio=0.31, 95% confidence interval 0.14-0.68, respectively). Overall survival was associated significantly with Basic Score for Brain Metastases (P=0.031), Score Index for Radiosurgery in Brain Metastases (P=0.007), and Graded Prognostic Assessment (P=0.003). Improvement in overall survival was observed in all groups of different prognostic scores. Conclusion: Frameless stereotactic brain radiosurgery is effective in patients with oligometastases of brain and should be increasingly considered in patients with favourable prognostic scoring.
Persistent Identifierhttp://hdl.handle.net/10722/249657
ISSN
2019 Impact Factor: 1.679
2015 SCImago Journal Rankings: 0.279
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorMok, ST-
dc.contributor.authorKam, MKM-
dc.contributor.authorTsang, WK-
dc.contributor.authorPoon, DMC-
dc.contributor.authorLoong, HH-
dc.contributor.authorYeung, WM-
dc.contributor.authorYeung, TY-
dc.contributor.authorYu, J-
dc.contributor.authorWong, CKH-
dc.date.accessioned2017-11-21T03:05:13Z-
dc.date.available2017-11-21T03:05:13Z-
dc.date.issued2017-
dc.identifier.citationHong Kong Medical Journal, 2017, v. 23 n. 6, p. 599–608-
dc.identifier.issn1024-2708-
dc.identifier.urihttp://hdl.handle.net/10722/249657-
dc.description.abstractIntroduction: Stereotactic brain radiosurgery provides good local control in patients with limited brain metastases. A newly developed frameless system allows pain-free treatment. We reviewed the effectiveness of this frameless stereotactic brain radiosurgery and identified prognostic factors that may aid better patient selection. Methods: Medical records of patients with brain metastases treated with linear accelerator–based frameless stereotactic brain radiosurgery between January 2010 and July 2015 in a university affiliated hospital in Hong Kong were reviewed. Outcomes including local and distant brain control rate, progression-free survival, and overall survival were analysed. Prognostic factors were identified by univariable and multivariable analyses. Association of outcomes with four common prognostic scores was performed. Results: In this study, 64 patients with 94 lesions were treated with a median dose of 18 Gy (range, 12-22 Gy) in a single fraction. The median follow-up was 11.5 months. One-year actuarial local and distant brain control rates were 72% and 71%, respectively. The median overall survival was 13.0 months. On multivariable analysis, Karnofsky performance status score (>50 vs ≤50) and number of lesions (1-2 vs ≥3) were found to associate significantly with distinct brain progression-free survival (P=0.022, hazard ratio=0.20, 95% confidence interval 0.05-0.80 and P=0.003, hazard ratio=0.31, 95% confidence interval 0.14-0.68, respectively). Overall survival was associated significantly with Basic Score for Brain Metastases (P=0.031), Score Index for Radiosurgery in Brain Metastases (P=0.007), and Graded Prognostic Assessment (P=0.003). Improvement in overall survival was observed in all groups of different prognostic scores. Conclusion: Frameless stereotactic brain radiosurgery is effective in patients with oligometastases of brain and should be increasingly considered in patients with favourable prognostic scoring.-
dc.languageeng-
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/-
dc.relation.ispartofHong Kong Medical Journal-
dc.rightsHong Kong Medical Journal. Copyright © Hong Kong Academy of Medicine Press.-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.titleFrameless stereotactic radiosurgery for brain metastases: a review of outcomes and prognostic scores evaluation-
dc.typeArticle-
dc.identifier.emailWong, CKH: carlosho@hku.hk-
dc.identifier.authorityWong, CKH=rp01931-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.12809/hkmj166138-
dc.identifier.scopuseid_2-s2.0-85037694150-
dc.identifier.hkuros283358-
dc.identifier.volume23-
dc.identifier.issue6-
dc.identifier.spage599–608-
dc.identifier.epage599–608-
dc.identifier.isiWOS:000418911400009-
dc.publisher.placeHong Kong-

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