Current status and recent advances in resection cavity irradiation of brain metastases

Radiation Oncology

Table 1 Selected studies of postoperative stereotactic radiosurgery (SRS) to surgical bed

References	Pts (No)	Date	Interval between surgery/SRS	SRS modality	Median SRS dose (Gy)	PTV (cc)	GTV-to-PTV margins	Median follow-up (months)
Jensen et al. [10]	106	2001–2009	3.5 w	GK	17 (11–23)	12.6 (1.2–74.0)	1 mm	NR
Rwigema et al. [11]	77	2005–2010	3–4 w	CK	12–27 in 1–3 fr (SRS 70%)	7.6 (0.5–59)	1 mm	13.8
Prabhu et al. [12]	62	2007–2010	4.5 w	LINAC	18	13.9 (1.6–80)	0–2 mm; > 1 mm (95%)	12.4
Robbins et al. [13]	85	2000–2011	within 8 w	LINAC	16	13.95	2–3 mm	11.2
Luther et al. [14]	120	2002–2012	4 w	GK	16	8	2–3 mm	12.6
Brennan et al. [15]	49	2208–2009	4 w (2–8)	LINAC	15–22	≥ 3 cm, 18 < 3 cm, 32	2 mm	12
Iorio-Morin et al. [16]	110	2004–2013	> 3w (60pts), < 3w (53pts)	GK	18	12 (0.6–43)	1 mm	10
Ojerholm et al. [17]	91	2007–2013	6 w	GK	16	9.2	0 mm	9.8
Abel et al. [18]	85	2003–2013	3–6 w	GK	17.3 (14–20)	12 (0.3–83)	0 mm	16.4
Eaton et al. [19]	75	2007–2014	NR	LINAC	SRS 15 (39 pts) HSRT 24–30/3–5 fr (36 pts)	SRS 20.5 HSRT 37.7	1.5–2 mm	15
Strauss et al. [20]	100	2005–2013	4 w	LINAC	20	4 ± 3.1 (mean)	0 mm	16.3 (mean)
Johnson et al. [21]	112	2006–2013	2–4 w	GK	16	9.85 (0.9–41.1)	0 mm	9
Rava et al. [22]	87	2002–2010	4 w	GK	18	13.4 (3–40.8)	1–2 mm	7.1
Brown et al. [7]	194	2011–2015	Within 4 w	LINAC/ GK/CK	SRS (12–18); WBRT (37.5/15)	NR	2 mm	11.1
Mahajan et al. [24]	128	2009–2016	Within 4 w	GK	16 (12–18)	NR	1 mm	11.1
Bachmann et al. [23]	75	2010–2015	NR	LINAC	SRS 18 HSRT 40/10fr	SRS 8.4; HSRT 22.6	1 mm	11.2

References	1-Year LC (%)	1-Year DP (%)	1-Year OS (%)	BED Gy₁₀ (Tumor)	BED Gy₂ (normal brain)	LMD (%)	Symptomatic RN (%)
Jensen et al. [10]	80.3	64.6	46.8	45.9 (23.1–75.9)	161.5 (71.5–287.5)	7	2.7
Rwigema et al. [11]	76	46	62.5	SRS 37.5 HSRT 51.3	SRS 127.5 HSRT 148.5	1.3	3
Prabhu et al. [12]	78	51	70	50.4	180	NR	8 at 1 year
Robbins et al. [13]	81.4	58.1	51.5	41.6	144	NR	8
Luther et al. [14]	87	40	63	41.6	144	NR	7.5
Brennan et al. [15]	78	44	50	37.5–70.4	127.5–264	NR	17.5
Iorio-Morin et al. [16]	< 3w 87 > 3w 61	54	63	50.4	180	11	22
Ojerholm et al. [17]	81	27	45	41.6	144	NR	7
Abel et al. [18]	87	52	65	47.2 (33.6–60)	166.9 (112–220)	NR	8
Eaton et al. [19]	SRS 27.2 HSRT 25.6	52	SRS 41.1 HSRT 54.9	SRS 37.5 HSRT 43.2–48	SRS 127.5 HSRT 120–126	NR	SRS 6.8 HSRT 16.4
Strauss et al. [20]	84	42	63.5	60	220	9.8	5
Johnson et al. [21]	84.4	50	12.9	41.6	144	16.9 at 1 year	NR
Rava et al. [22]	82	44	54	50.4	180	NR	10.3
Brown et al. [7]	SRS 60.5 WBRT 80·6 (p = 0.00068)	SRS 35 WBRT 11 (p = 0.0004)	SRS 50 WBRT 48	SRS 26.4–50.4 WBRT 46.8	SRS 84–180 WBRT 84.4	SRS 7.2 WBRT 6.4	4 (all after SRS)
Mahajan et al. [24]	SRS 57 OBS 28 (p = 0.0015)	SRS 58 OBS 67	SRS 65 OBS 63	41.6 26.4–50.4	144 84–180	SRS 28 OBS 16	NR
Bachmann et al. [23]	72	40	64	SRS 50.4 HSRT 56	SRS 180 HSRT 120	NR	22

LINAC, linear accelerator; GK, Gamma Knife; CK, CyberKnife; SRS, stereotactic radiosurgery; WBRT, whole brain radiation therapy; HSRT, hypofractionated stereotactic radiation therapy; OBS, observation; p, prospective; BED Gy10, biological equivalent dose with an α/β ratio of 10 Gy; BED Gy2, biological equivalent dose with an α/β ratio of 2 Gy; w, weeks; LC, local control; DP, dostant progression; OS, overall survival; NR, not reported

ISSN: 1748-717X