Related Experiment Video
Updated: Aug 20, 2025
Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy
Published on: May 8, 2018
Fractionated stereotactic radiotherapy as a primary or salvage treatment for large brainstem metastasis
Georgios Chatzikonstantinou1, Robert Wolff2, Nikolaos Tselis3
1Department of Radiotherapy and Oncology, University Hospital, Goethe University Frankfurt, Frankfurt; Saphir Radiosurgery Center, Frankfurt am Main, Germany.
Introduction:
This study aimed to determine the efficacy and safety of robotic-based fractionated stereotactic radiotherapy (FSRT) in the treatment of large brainstem metastases (BSMs).
Methods:
Ten BSM were treated in ten patients with FSRT between January 2012 and December 2018. The median age was 61 years (range, 53-74 years) with a median Karnofsky Performance Score of 80 (range, 70-90). Four patients (40%) had received whole-brain radiotherapy prior to FSRT. The median tumor volume was 4.2 cm3 (range, 1.35-8.18 cm3) with a median prescription dose of 24 Gy (range, 16-24 Gy) delivered in 3-5 fractions (median three fractions) to the 56%-83% isodose line (median 70.5%).
Results:
1Median follow-up for the entire cohort was 14.1 months (range, 4.6-19.3 months). Five local recurrences were documented. Local control (LC) rate at 6 and 12 months was 90% and 64.2%, respectively. The median tumor volume of patients developing local recurrence was 5.42 cm3. Three patients experienced intracranial out-of-field failure for a 12-month intracranial control rate of 78.7%. Median overall survival and time to extracranial progression were 14.7 and 16.8 months, respectively. Toxicity was low with only one patient developing a new hemiparesis.
Conclusion:
Robotic-based FSRT for BSM appears to be safe with favorable LC and low toxicity even for large tumors.
