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. 2022 Aug 24;29(9):6068-6076.
doi: 10.3390/curroncol29090477.

Long-Term Survival after Linac-Based Stereotactic Radiosurgery and Radiotherapy with a Micro-Multileaf Collimator for Brain Metastasis

Ryosuke Matsuda  1 , Masatoshi Hasegawa  2 , Tetsuro Tamamoto  2   3 , Nobuyoshi Inooka  2 , Mei Nikimoto  2 , Tomoko Ochi  4 , Toshiteru Miyasaka  4 , Shigeto Hontsu  5 , Kaori Yamaki  2 , Sachiko Miura  2 , Takayuki Morimoto  1 , Takaaki Mitsui  1 , Takanori Furuta  1 , Shohei Yokoyama  1 , Masashi Kotsugi  1 , Shuichi Yamada  1 , Ichiro Nakagawa  1 , Young-Soo Park  1 , Hiroyuki Nakase  1
Affiliations

Long-Term Survival after Linac-Based Stereotactic Radiosurgery and Radiotherapy with a Micro-Multileaf Collimator for Brain Metastasis

Ryosuke Matsuda et al. Curr Oncol. .

Abstract

Background: this study aimed to evaluate the prognostic factors associated with long-term survival after linear accelerator (linac)-based stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT) with a micro-multileaf collimator for brain metastasis (BM).

Methods: This single-center retrospective study included 226 consecutive patients with BM who were treated with linac-based SRS or fSRT with a micro-multileaf collimator between January 2011 and December 2018. Long-term survival (LTS) was defined as survival for more than 2 years after SRS/fSRT.

Results: The tumors originated from the lung (n = 189, 83.6%), breast (n = 11, 4.9%), colon (n = 9, 4.0%), stomach (n = 4, 1.8%), kidney (n = 3, 1.3%), esophagus (n = 3, 1.3%), and other regions (n = 7, 3.1%). The median pretreatment Karnofsky performance scale (KPS) score was 90 (range: 40-100). The median follow-up time was 13 (range: 0-120) months. Out of the 226 patients, 72 (31.8%) were categorized in the LTS group. The median survival time was 43 months and 13 months in the LTS group and in the entire cohort, respectively. The 3-year, 4-year, and 5-year survival rate in the LTS group was 59.1%, 49.6%, and 40.7%, respectively. Multivariate regression logistic analysis showed that female sex, a pre-treatment KPS score ≥ 80, and the absence of extracranial metastasis were associated with long-term survival.

Conclusions: female sex, a favorable pre-treatment KPS score, and the absence of extracranial metastasis were associated with long-term survival in the current cohort of patients with BM.

Keywords: brain metastasis; linac with a micro-multileaf collimator; long-term survivors; stereotactic radiosurgery; stereotactic radiotherapy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Treatment outcomes. Overall survival of the entire cohort of patients with brain metastases (A), distant failure of the STS (black line) and LTS (red line) groups (B), local failure of the STS (black line) and LTS (red line) groups (C) estimated using the Kaplan–Meier method.
See this image and copyright information in PMC

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