Author, year | Patients/ Lesions | Treatment options | Dose | Local Control (LC) | Predictive factors | Complication (%) |
---|---|---|---|---|---|---|
Noel G, [5] | 92/ 145 | SRS alone: 34 (37%) | WBRT: 30Gy/10 or 40Gy/20 | 6-months: 93% 1-y: 86% | high maximal dose delivered at the isocentre of the GTV | 8 - radiation necrosis (5.5%) |
SRS + WBRT: 22 (24%) | SRS alone: 14Gy* | SRS alone: | 1 - seizure | |||
WBRT + salvage SRS: 36 (39%) | SRS plus WBRT: 10Gy* | 6-m: 90% 1-y: 78% | ||||
* On 70% isodose line | SRS + WBRT: 6-m/1-y: 90% | |||||
WBRT + SRS: | ||||||
6-m: 92% 1-y: 86% (NS) | ||||||
Noel G, [6] | 54/ 97 | WBRT + salvage SRS | WBRT: 30-40Gy | 1-y: 91.3% 2-y: 84% | no prognostic factors for local control | no major complications |
SRS | ||||||
minimun dose: 14.4Gy (12.3-19.3) | 2 - transient headaches secondary to edema | |||||
maximum dose: 20.9 Gy (17.3-38.8) | 2 - temporary grade 2 alopecia | |||||
Vogelbaum, [12] | 202/ 375 | SRS alone: 48 (24%) | ≤20 mm: 24Gy | median: | dose to the tumor margin | 6 - proven radiation necrosis |
SRS + WBRT: 37 (18%) | 21-30 mm: 18Gy | 24Gy: NR** 18Gy: 11,57 m 15Gy: 11,83 m | ||||
WBRT + salvage SRS: 117 (58%) | 31-40 mm: 15Gy | 1-y 24Gy: 85%** 18Gy: 49% 15Gy: 45% | ||||
* At tumor margin (50% isodose line), independent if previous WBRT or not | ** for 24 Gy compared with 18 or 15 Gy | |||||
Shehata, [13] | 160/ 468 | SRS alone: 228 mets (49%) | planned WBRT: 6.75– 50.4 Gy (median 40.5 Gy) | Overall LC | addition of WBRT | trend toward greater complications (RTOG Grade 3 or 4) for SRS doses >20 × ≤20 Gy (p = 0.078) |
SRS + planned WBRT: 240 mets (51%) | SRS: 7-30Gy at the 40–95% isodose (median 60%) | SRS alone: 87% SRS + WBRT: 97% | If planned WBRT - dose | |||
maximal dose:10.7-50 Gy (median 30 Gy) | 1-y | tumor volume | ||||
SRS alone: 77% SRS + WBRT: 96% ** | ||||||
SRS < 20 Gy + WBRT: 91% | ||||||
SRS ≥ 20 Gy + WBRT: 99%** | ||||||
If 20Gy: 99% >20Gy: 96% (NS) | ||||||
Schomas, [14] | 80/ 126 | SRS alone: 11 (14%) | WBRT: 25–46 Gy in 2–3 Gy | 1-y: 88.6% | minimum target dose | 3 patients (5%) |
SRS + planned WBRT: 69 (86%) | SRS: 18 Gy (10–21) | SRS + WBRT: 88.8% | 2 - edema | |||
SRS alone: 87.5% (NS) | 1 - radiation necrosis (confirmed by resection) | |||||
Per dose ** ≤ 12Gy: 66.7% | 2- within SRS field | |||||
12.1-18Gy: 93.8% | 1- outside field (previous WBRT) | |||||
>18Gy: 93.3% | ||||||
2-y: 77.2% | ||||||
Chao, [15] | 111/ NA | WBRT + salvage SRS | WBRT: 37.5 Gy (30–50) | 1-y: 68% | tumor size dose | 2 - radiation necrosis (5,5 months and 1.5 year after SRS) |
SRS: | 2-y: 59% | 1 - seizure | ||||
≤20 mm: 24Gy 21-30 mm: 18Gy | ||||||
31-40 mm: 15Gy | ||||||
>40 mm: 12Gy | ||||||
Chang, [16] | 135/ 153 | SRS alone: 71 (52,6%) | WBRT: 30Gy (22.5-40Gy) | 1-y: 69% | tumor volume cone diameter | edema with mass effect (14%) |
SRS + WBRT: 30 (22,2%) | SRS | ≤1 × > 1 cm: 86 × 56%** | Pathologically proven necrosis (1,3%) | |||
WBRT + salvage SRS: 32 (23,7%) | Minimum peripheral dose: 20-24Gy | 2-y: 46% | Hemorrhage (4,6%) | |||
≤1 × > 1 cm: 78 × 24%** | ||||||
Our series, 2015 | 100/216 | SRS alone: 121 (56%) | WBRT: 30 Gy (median) | 1-y: | dose at the PTV margin | 8 – asymptomatic radiation necrosis |
WBRT + salvage SRS: 95 (44%) | SRS alone: 20 Gy (median) | SRS alone: 78.4% | 2 – symptomatic radiation necrosis | |||
WBRT + salvage SRS: 16 Gy (median) | WBRT + SRS: 57.9%** | |||||
Per dose**: | ||||||
≤15 Gy: 39.6% | ||||||
16-20Gy: 71.7% | ||||||
≥21 Gy: 92.3 |