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RESULTS OF TREATMENT LARGE BRAIN METASTASIS WITH TWO FRACTIONED GAMMA KNIFE RADIOSURGERY AT K HOSPITAL
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Abstract
Purpose: The optimal interfraction intervals for fractionated radiosurgery has yet to be established. Our study aimed to evaluate the preliminary treatment result of 2-staged stereotactic radiosurgery by Gamma Knife for large brain metastases. Methods: All patients underwent 2-staged Gamma Knife radiosurgery for large brain metastases using the ICON unit at K hospital, Hanoi,VietNam from 7/2019 to 6/2022. All patients had 1-5 brain metastases, at least 1 large brain metastasis with the largest diameter > 3cm or the volume >10cc, treatment dose 12 Gy x 2 fractions, time between two fractions is 2 weeks. Results: Total were 50 patients in this study, mean of tumor volume at first treatment was 18,13 ± 6,98 cc, and 13,24 ± 6,56 cc at the second treatment (volume reduction 27.24%, p = 0.003). The local tumor control rate of 50 large brain metastases was 94% at 3 months, 34% complete response, 52% partial response, 8% stable disease. The estimated local control rate was 88% and 76% at 6 months and 12 months, respectively. New brain metastases have not deverloped during 3 months follow up period. Amongs 50 lesions, 6 (12%) show radiation-induced adverse effects (8% Grade 1 and 2 toxicity, 4% Grade 3). The sstimated overall survival rates at 6 and 12 months were 92% ± 4% and 74% ± 6%, respectively. Conclusion: According to our results, we suggest that 2-staged Gamma Knife radiosurgery with a 2 weeks interval can be one of the effective treatment method for large brain metastases
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Keywords
staged radiosurgery, large brain metastases. Gamma knife.
References
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