Linear-accelerator-based hypofractionated radiotherapy for large brain metastases in Korea: a retrospective cohort study.
Purpose: The use of hypofractionated stereotactic radiotherapy (HFSRT) for large brain metastases has been steadily increasing. This study aimed to evaluate the efficacy and safety of linear accelerator-based HFSRT as a primary treatment option for large brain metastases without prior surgical resec...
| Publicado en: | Journal of the Korean Medical Association / Taehan Uisa Hyophoe Chi Vol. 68; no. 10; pp. 699 - 714 |
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| Autores principales: | , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Korean Medical Association
Oct2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=189216260&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 189216260 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 19758456 B9M7 jtl: Journal of the Korean Medical Association / Taehan Uisa Hyophoe Chi issn: 19758456 maglogo: N pubinfo: dt: Oct2025 vid: 68 iid: 10 pid: 64891 pub: Korean Medical Association place: , <Blank> artinfo: ui: 189216260 189216260 189216260 10.5124/jkma.25.0050 189216260 ppf: 699 ppct: 15 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Linear-accelerator-based hypofractionated radiotherapy for large brain metastases in Korea: a retrospective cohort study. aug: au: Baek, Yo-Han Shin, Dong-Won Yee, Gi-Taek affil: Department of Neurosurgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea sug: subj: Radiotherapy Particle Accelerators Utilization Radiation Dosage Therapeutic Use Brain Neoplasms Neoplasm Metastasis Treatment Outcomes Evaluation Patient Safety Evaluation Human South Korea Male Female Retrospective Design Prospective Studies Middle Age Aged Aged, 80 and Over Tomography, X-Ray Computed Magnetic Resonance Imaging Contrast Media Diagnostic Use Intracranial Hemorrhage Radiation Injuries Data Analysis Software Descriptive Statistics Chi Square Test T-Tests Univariate Statistics Kaplan-Meier Estimator Cox Proportional Hazards Model ROC Curve Tumor Burden Carcinoma, Hepatocellular Colorectal Neoplasms Breast Neoplasms Progression-Free Survival Overall Survival Confidence Intervals Edema Sensitivity and Specificity Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Purpose: The use of hypofractionated stereotactic radiotherapy (HFSRT) for large brain metastases has been steadily increasing. This study aimed to evaluate the efficacy and safety of linear accelerator-based HFSRT as a primary treatment option for large brain metastases without prior surgical resection. Methods: Between December 2013 and April 2022, 17 patients with brain metastases larger than 10 cm³ underwent HFSRT. Local control was assessed on a per-lesion basis. HFSRT was delivered using linear accelerator equipment (Novalis Tx; Varian Medical Systems). Results: Fourteen patients (82.4%) received 3 treatment fractions, while 2 patients received 2 and 5 fractions, respectively. Radiation-induced acute toxicity was reported in one case within the 3-fraction group, presenting with headache and vomiting. For multiple lesions, the median time to local failure was 0.2 months, compared with 2.8 months for single lesions (P=0.011). The 1-year local control rate was 68.2%. The 1-year overall survival (OS) rate was 29.4%, and the 2-year OS rate was 11.8% for the total cohort. Conclusion: Linear accelerator-based HFSRT is both effective and safe for the treatment of large brain metastases and may be considered a primary treatment approach. In this study, the 1-year local control rate and 1-year survival rate were 68.2% and 29.4%, respectively. To reduce the risk of posttreatment swelling, the total dose should not exceed a biologically effective dose of 64.65 Gy, and delivery in 3 fractions appears safe with respect to radiation toxicity. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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