Stereotactic Radiosurgery for Brainstem Metastases: An International Cooperative Study to Define Response and Toxicity

Daniel Trifiletti, Cheng Chia Lee, Hideyuki Kano, Jonathan Cohen, James Janopaul-Naylor, Michelle Alonso-Basanta, John Y.K. Lee, Gabriela Simonova, Roman Liscak, Amparo Wolf, Svetlana Kvint, Inga S. Grills, Matthew Johnson, Kang Du Liu, Chung Jung Lin, David Mathieu, France Héroux, Danilo Silva, Mayur Sharma, Christopher P. CifarelliChristopher N. Watson, Joshua D. Hack, John G. Golfinos, Douglas Kondziolka, Gene Barnett, L. Dade Lunsford, Jason P. Sheehan

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Purpose To pool data across multiple institutions internationally and report on the cumulative experience of brainstem stereotactic radiosurgery (SRS). Methods and Materials Data on patients with brainstem metastases treated with SRS were collected through the International Gamma Knife Research Foundation. Clinical, radiographic, and dosimetric characteristics were compared for factors prognostic for local control (LC) and overall survival (OS) using univariate and multivariate analyses. Results Of 547 patients with 596 brainstem metastases treated with SRS, treatment of 7.4% of tumors resulted in severe SRS-induced toxicity (grade ≥3, increased odds with increasing tumor volume, margin dose, and whole-brain irradiation). Local control at 12 months after SRS was 81.8% and was improved with increasing margin dose and maximum dose. Overall survival at 12 months after SRS was 32.7% and impacted by age, gender, number of metastases, tumor histology, and performance score. Conclusions Our study provides additional evidence that SRS has become an option for patients with brainstem metastases, with an excellent benefit-to-risk ratio in the hands of experienced clinicians. Prior whole-brain irradiation increases the risk of severe toxicity in brainstem metastasis patients undergoing SRS.

Original languageEnglish (US)
Pages (from-to)280-288
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume96
Issue number2
DOIs
StatePublished - Oct 1 2016
Externally publishedYes

Fingerprint

Radiosurgery
metastasis
toxicity
Brain Stem
Neoplasm Metastasis
tumors
dosage
brain
margins
irradiation
histology
grade
Survival
Brain
Tumor Burden
Neoplasms
Histology
Multivariate Analysis
Odds Ratio
Research

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Stereotactic Radiosurgery for Brainstem Metastases : An International Cooperative Study to Define Response and Toxicity. / Trifiletti, Daniel; Lee, Cheng Chia; Kano, Hideyuki; Cohen, Jonathan; Janopaul-Naylor, James; Alonso-Basanta, Michelle; Lee, John Y.K.; Simonova, Gabriela; Liscak, Roman; Wolf, Amparo; Kvint, Svetlana; Grills, Inga S.; Johnson, Matthew; Liu, Kang Du; Lin, Chung Jung; Mathieu, David; Héroux, France; Silva, Danilo; Sharma, Mayur; Cifarelli, Christopher P.; Watson, Christopher N.; Hack, Joshua D.; Golfinos, John G.; Kondziolka, Douglas; Barnett, Gene; Lunsford, L. Dade; Sheehan, Jason P.

In: International Journal of Radiation Oncology Biology Physics, Vol. 96, No. 2, 01.10.2016, p. 280-288.

Research output: Contribution to journalArticle

Trifiletti, D, Lee, CC, Kano, H, Cohen, J, Janopaul-Naylor, J, Alonso-Basanta, M, Lee, JYK, Simonova, G, Liscak, R, Wolf, A, Kvint, S, Grills, IS, Johnson, M, Liu, KD, Lin, CJ, Mathieu, D, Héroux, F, Silva, D, Sharma, M, Cifarelli, CP, Watson, CN, Hack, JD, Golfinos, JG, Kondziolka, D, Barnett, G, Lunsford, LD & Sheehan, JP 2016, 'Stereotactic Radiosurgery for Brainstem Metastases: An International Cooperative Study to Define Response and Toxicity', International Journal of Radiation Oncology Biology Physics, vol. 96, no. 2, pp. 280-288. https://doi.org/10.1016/j.ijrobp.2016.06.009
Trifiletti, Daniel ; Lee, Cheng Chia ; Kano, Hideyuki ; Cohen, Jonathan ; Janopaul-Naylor, James ; Alonso-Basanta, Michelle ; Lee, John Y.K. ; Simonova, Gabriela ; Liscak, Roman ; Wolf, Amparo ; Kvint, Svetlana ; Grills, Inga S. ; Johnson, Matthew ; Liu, Kang Du ; Lin, Chung Jung ; Mathieu, David ; Héroux, France ; Silva, Danilo ; Sharma, Mayur ; Cifarelli, Christopher P. ; Watson, Christopher N. ; Hack, Joshua D. ; Golfinos, John G. ; Kondziolka, Douglas ; Barnett, Gene ; Lunsford, L. Dade ; Sheehan, Jason P. / Stereotactic Radiosurgery for Brainstem Metastases : An International Cooperative Study to Define Response and Toxicity. In: International Journal of Radiation Oncology Biology Physics. 2016 ; Vol. 96, No. 2. pp. 280-288.
@article{f798f3f27603498a9aafa2b95293b90c,
title = "Stereotactic Radiosurgery for Brainstem Metastases: An International Cooperative Study to Define Response and Toxicity",
abstract = "Purpose To pool data across multiple institutions internationally and report on the cumulative experience of brainstem stereotactic radiosurgery (SRS). Methods and Materials Data on patients with brainstem metastases treated with SRS were collected through the International Gamma Knife Research Foundation. Clinical, radiographic, and dosimetric characteristics were compared for factors prognostic for local control (LC) and overall survival (OS) using univariate and multivariate analyses. Results Of 547 patients with 596 brainstem metastases treated with SRS, treatment of 7.4{\%} of tumors resulted in severe SRS-induced toxicity (grade ≥3, increased odds with increasing tumor volume, margin dose, and whole-brain irradiation). Local control at 12 months after SRS was 81.8{\%} and was improved with increasing margin dose and maximum dose. Overall survival at 12 months after SRS was 32.7{\%} and impacted by age, gender, number of metastases, tumor histology, and performance score. Conclusions Our study provides additional evidence that SRS has become an option for patients with brainstem metastases, with an excellent benefit-to-risk ratio in the hands of experienced clinicians. Prior whole-brain irradiation increases the risk of severe toxicity in brainstem metastasis patients undergoing SRS.",
author = "Daniel Trifiletti and Lee, {Cheng Chia} and Hideyuki Kano and Jonathan Cohen and James Janopaul-Naylor and Michelle Alonso-Basanta and Lee, {John Y.K.} and Gabriela Simonova and Roman Liscak and Amparo Wolf and Svetlana Kvint and Grills, {Inga S.} and Matthew Johnson and Liu, {Kang Du} and Lin, {Chung Jung} and David Mathieu and France H{\'e}roux and Danilo Silva and Mayur Sharma and Cifarelli, {Christopher P.} and Watson, {Christopher N.} and Hack, {Joshua D.} and Golfinos, {John G.} and Douglas Kondziolka and Gene Barnett and Lunsford, {L. Dade} and Sheehan, {Jason P.}",
year = "2016",
month = "10",
day = "1",
doi = "10.1016/j.ijrobp.2016.06.009",
language = "English (US)",
volume = "96",
pages = "280--288",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Stereotactic Radiosurgery for Brainstem Metastases

T2 - An International Cooperative Study to Define Response and Toxicity

AU - Trifiletti, Daniel

AU - Lee, Cheng Chia

AU - Kano, Hideyuki

AU - Cohen, Jonathan

AU - Janopaul-Naylor, James

AU - Alonso-Basanta, Michelle

AU - Lee, John Y.K.

AU - Simonova, Gabriela

AU - Liscak, Roman

AU - Wolf, Amparo

AU - Kvint, Svetlana

AU - Grills, Inga S.

AU - Johnson, Matthew

AU - Liu, Kang Du

AU - Lin, Chung Jung

AU - Mathieu, David

AU - Héroux, France

AU - Silva, Danilo

AU - Sharma, Mayur

AU - Cifarelli, Christopher P.

AU - Watson, Christopher N.

AU - Hack, Joshua D.

AU - Golfinos, John G.

AU - Kondziolka, Douglas

AU - Barnett, Gene

AU - Lunsford, L. Dade

AU - Sheehan, Jason P.

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Purpose To pool data across multiple institutions internationally and report on the cumulative experience of brainstem stereotactic radiosurgery (SRS). Methods and Materials Data on patients with brainstem metastases treated with SRS were collected through the International Gamma Knife Research Foundation. Clinical, radiographic, and dosimetric characteristics were compared for factors prognostic for local control (LC) and overall survival (OS) using univariate and multivariate analyses. Results Of 547 patients with 596 brainstem metastases treated with SRS, treatment of 7.4% of tumors resulted in severe SRS-induced toxicity (grade ≥3, increased odds with increasing tumor volume, margin dose, and whole-brain irradiation). Local control at 12 months after SRS was 81.8% and was improved with increasing margin dose and maximum dose. Overall survival at 12 months after SRS was 32.7% and impacted by age, gender, number of metastases, tumor histology, and performance score. Conclusions Our study provides additional evidence that SRS has become an option for patients with brainstem metastases, with an excellent benefit-to-risk ratio in the hands of experienced clinicians. Prior whole-brain irradiation increases the risk of severe toxicity in brainstem metastasis patients undergoing SRS.

AB - Purpose To pool data across multiple institutions internationally and report on the cumulative experience of brainstem stereotactic radiosurgery (SRS). Methods and Materials Data on patients with brainstem metastases treated with SRS were collected through the International Gamma Knife Research Foundation. Clinical, radiographic, and dosimetric characteristics were compared for factors prognostic for local control (LC) and overall survival (OS) using univariate and multivariate analyses. Results Of 547 patients with 596 brainstem metastases treated with SRS, treatment of 7.4% of tumors resulted in severe SRS-induced toxicity (grade ≥3, increased odds with increasing tumor volume, margin dose, and whole-brain irradiation). Local control at 12 months after SRS was 81.8% and was improved with increasing margin dose and maximum dose. Overall survival at 12 months after SRS was 32.7% and impacted by age, gender, number of metastases, tumor histology, and performance score. Conclusions Our study provides additional evidence that SRS has become an option for patients with brainstem metastases, with an excellent benefit-to-risk ratio in the hands of experienced clinicians. Prior whole-brain irradiation increases the risk of severe toxicity in brainstem metastasis patients undergoing SRS.

UR - http://www.scopus.com/inward/record.url?scp=84979747827&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84979747827&partnerID=8YFLogxK

U2 - 10.1016/j.ijrobp.2016.06.009

DO - 10.1016/j.ijrobp.2016.06.009

M3 - Article

C2 - 27478166

AN - SCOPUS:84979747827

VL - 96

SP - 280

EP - 288

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 2

ER -