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...

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Publicado en:Journal of the Korean Medical Association / Taehan Uisa Hyophoe Chi Vol. 68; no. 10; pp. 699 - 714
Autores principales: Baek, Yo-Han, Shin, Dong-Won, Yee, Gi-Taek
Formato: diagnostic images research tables/charts Journal Article
Publicado: Korean Medical Association Oct2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2025
      vid: 68
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      pub: Korean Medical Association
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        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
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