PLoS ONE (Jan 2018)

Second course of stereotactic radiosurgery for locally recurrent brain metastases: Safety and efficacy.

  • Juliette Moreau,
  • Toufic Khalil,
  • Guillaume Dupic,
  • Emmanuel Chautard,
  • Jean-Jacques Lemaire,
  • Florian Magnier,
  • Véronique Dedieu,
  • Michel Lapeyre,
  • Pierre Verrelle,
  • Julian Biau

DOI
https://doi.org/10.1371/journal.pone.0195608
Journal volume & issue
Vol. 13, no. 4
p. e0195608

Abstract

Read online

In the present study, we have evaluated the efficacy and toxicity of repeated brain metastases (BM) stereotactic radiosurgery (SRS2) following local failure of a prior radiosurgical procedure (SRS1). Between December 1996 and August 2015, 30 patients with 36 BM underwent SRS2 with a median dose of 18Gy. All BM were located outside critical structures. Following SRS2, local control at 6 months and one year were respectively 82.9% (IC 95%: 67.6-91.9) and 67.8% (IC 95%: 51-81). On multivariate analysis, planning target volume (PTV) 7cc (p = 0.02) and all patients had a WBRT before SRS2. A second course of SRS for locally recurrent brain metastases showed encouraging rates of local control. This treatment led to acceptable toxicities, especially for brain metastases smaller than 7cc, in our selected cohort of patients with BM located outside critical structures. Further studies are needed.