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Frameless Stereotactic Radiosurgery With Linear Accelerator (LINAC)-Based Technology for Brain Metastases: Outcomes
Aisin Ibrahim1, Bernard Fortin2, Alexis Bujold2
1Department of Diagnostic Radiology, McGill University, Montréal, CAN.
Cureus
|July 15, 2021
Summary
Frameless stereotactic radiosurgery (SRS) using linear accelerator (LINAC) technology offers effective treatment for brain metastases (BM), demonstrating comparable survival rates to traditional methods with fewer side effects and minimal radiation necrosis.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Medical Physics
Background:
- Brain metastases (BM) are the most frequent intracranial tumors in adults.
- Conventional treatments include surgery and frame-based stereotactic radiosurgery (SRS).
- Frameless SRS presents a less invasive alternative with potentially fewer side effects.
Purpose of the Study:
- To evaluate the therapeutic outcomes and toxicity of frameless SRS using LINAC-based technology for BM treatment.
- To assess progression-free survival, local control, overall survival, and treatment-related toxicity.
Main Methods:
- Retrospective study of adult patients treated with frameless SRS for BM (October 2010 - July 2016).
- Routine follow-up with MRI scans at three-month intervals.
- Survival analysis using Kaplan-Meier method and competing risk analyses for cumulative incidences.
Main Results:
- 194 metastatic lesions in 141 patients were treated.
- Median overall survival was 8.7 months; median progression-free survival was 5.3 months.
- Local recurrence rates were 25% (1 year) and 38% (2 years); radiation necrosis incidence was 2% (1 and 2 years).
Conclusions:
- LINAC-based frameless SRS for BM shows survival outcomes comparable to existing SRS methods.
- Frameless SRS is a safe, less invasive, and more comfortable option for BM treatment.
- Minimal rates of radiation necrosis were observed, indicating a favorable safety profile.
