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      Single isocenter stereotactic irradiation for multiple brain metastases: current situation and prospects

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          Abstract

          The prognosis of patients with brain metastases has dramatically improved, and long-term tumor control and reduction of the risk of late toxicities, including neurocognitive dysfunction, are important for patient quality of life. Stereotactic irradiation for multiple brain metastases, rather than whole-brain radiotherapy, can result in high local control rate with low incidence of neurocognitive deterioration and leukoencephalopathy. Recent advances in radiotherapy devices, treatment-planning systems, and image-guided radiotherapy can realize single isocenter stereotactic irradiation for multiple brain metastases (SI-STI-MBM), in which only one isocenter is sufficient to treat multiple brain metastases simultaneously. SI-STI-MBM has expanded the indications for linear accelerator-based stereotactic irradiation and considerably reduced patient burden. This review summarizes the background, methods, clinical outcomes, and specific consideration points of SI-STI-MBM. In addition, the prospects of SI-STI-MBM are addressed.

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          Incidence proportions of brain metastases in patients diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System.

          Jill Barnholtz-Sloan, Andrew Sloan, Faith G. Davis … (2004)
          Population-based estimates of the incidence of brain metastases are not generally available. The purpose of this study was to calculate population-based incidence proportions (IPs) of brain metastases from single primary lung, melanoma, breast, renal, or colorectal cancer. Patients diagnosed with single primary lung, melanoma, breast, renal, or colorectal cancer (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System (MDCSS) were used for analysis. IP of brain metastases by primary site and variable of interest (race, sex, age at diagnosis of primary cancer, and Surveillance, Epidemiology, and End Results [SEER] stage of primary cancer) was calculated with 95% CIs. Total IP percentage (IP%) of brain metastases was 9.6% for all primary sites combined, and highest for lung (19.9%), followed by melanoma (6.9%), renal (6.5%), breast (5.1%), and colorectal (1.8%) cancers. Racial differences were seen with African Americans demonstrating higher IP% of brain metastases compared with other racial groups for most primary sites. IP% was significantly higher for female patients with lung cancer, and significantly higher for male patients with melanoma. The highest IP% of brain metastases occurred at different ages at diagnoses: age 40 to 49 years for primary lung cancer; age 50 to 59 years for primary melanoma, renal, or colorectal cancers; and age 20 to 39 for primary breast cancer. IP% significantly increased as SEER stage of primary cancer advanced for all primary sites. Total IP% of brain metastases was lower than previously reported, and it varied by primary site, race, sex, age at diagnosis of primary cancer, and SEER stage of primary cancer.
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            Postoperative stereotactic radiosurgery compared with whole brain radiotherapy for resected metastatic brain disease (NCCTG N107C/CEC·3): a multicentre, randomised, controlled, phase 3 trial.

            Paul D. Brown, Karla V. Ballman, Jane H Cerhan … (2017)
            Whole brain radiotherapy (WBRT) is the standard of care to improve intracranial control following resection of brain metastasis. However, stereotactic radiosurgery (SRS) to the surgical cavity is widely used in an attempt to reduce cognitive toxicity, despite the absence of high-level comparative data substantiating efficacy in the postoperative setting. We aimed to establish the effect of SRS on survival and cognitive outcomes compared with WBRT in patients with resected brain metastasis.
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              Effect of Radiosurgery Alone vs Radiosurgery With Whole Brain Radiation Therapy on Cognitive Function in Patients With 1 to 3 Brain Metastases: A Randomized Clinical Trial.

              Paul D. Brown, Kurt Jaeckle, Karla V. Ballman … (2016)
              Whole brain radiotherapy (WBRT) significantly improves tumor control in the brain after stereotactic radiosurgery (SRS), yet because of its association with cognitive decline, its role in the treatment of patients with brain metastases remains controversial.
              Article 0 comments Cited 347 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Takashi Mizowaki:
                ORCID: http://orcid.org/0000-0002-8135-8746
                mizo@kuhp.kyoto-u.ac.jp
                Journal
                Journal ID (nlm-ta): Jpn J Radiol
                Journal ID (iso-abbrev): Jpn J Radiol
                Title: Japanese Journal of Radiology
                Publisher: Springer Nature Singapore (Singapore )
                ISSN (Print): 1867-1071
                ISSN (Electronic): 1867-108X
                Publication date (Electronic): 3 September 2022
                Publication date PMC-release: 3 September 2022
                Publication date (Print): 2022
                Volume: 40
                Issue: 10
                Pages: 987-994
                Affiliations
                GRID grid.258799.8, ISNI 0000 0004 0372 2033, Department of Radiation Oncology and Image-Applied Therapy, , Kyoto University Graduate School of Medicine, ; 54, Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
                Author information
                http://orcid.org/0000-0002-8135-8746
                Article
                Publisher ID: 1333
                DOI: 10.1007/s11604-022-01333-7
                PMC ID: 9529683
                PubMed ID: 36057071
                SO-VID: 4fb4ef0c-34a8-4212-9e20-23364fd92429
                Copyright © © The Author(s) 2022
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date received : 14 June 2022
                Date accepted : 24 August 2022
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000646, Japan Society for the Promotion of Science London;
                Award ID: 21K15548
                Award Recipient :
                Categories
                Subject: Invited Review
                Custom metadata
                issue-copyright-statement © The Author(s) under exclusive licence to Japan Radiological Society 2022

                Keywords: single isocenter stereotactic irradiation,multiple brain metastases,linear accelerators
                Data availability:
                Keywords: single isocenter stereotactic irradiation, multiple brain metastases, linear accelerators

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