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© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Whole-brain radiation therapy and stereotactic radiosurgery are two treatment modalities commonly utilized to treat brain metastases (BMs). The aim of this study is to retrospectively analyze the main radio-oncologic and clinical-demographic aspects of a cohort of BM patients treated with Volumetric Modulated Arc Therapy for radiosurgery (VMAT-RS). This is a cross-sectional observational design study with a retrospective review of the medical records of patients with brain metastases treated with VMAT-RS between 2012 and 2018. Clinical and demographic data, with special attention to sex, age, primary tumor, brain tumor-related epilepsy (BTRE), number and brain location of BMs, Karnofsky Performance Status (KPS), the updated DS-GPA prognostic index, and the survival estimated according to the Kaplan–Meier model from the date of radiosurgery, were analyzed. One hundred and twenty-one patients with 229 BMs were treated with VMAT-RS. Patients presented 1–4 BMs, which were treated with five non-coplanar VMAT arcs. Sixty-eight percent of the patients had lung cancer, and 35% of the BMs were in the frontal lobe. The proportion of local control was 88.5%. BTRE prevalence was 30.6%. The median survival time (MST) was 7.7 months. In the multivariate analysis of the Cox regression model, KPS ≥ 70 (HRKPS < 70 = 2.59; p = 0.001) and higher DS-GPA (HRDS-GPAII = 0.55, p = 0.022; HRDS-GPAIII-IV = 0.38, p = 0.006) were associated with improved survival. In the univariate analysis, primary tumor, age, and the presence of metastases in the posterior fossa (PFBMs) were also significant. In conclusion, the VMAT-RS is a technique with an overall survival rate comparable to other radiosurgery techniques. The median survival is significantly longer for those with higher KPS and DS-GPA. Other variables, such as the type of primary tumor, age, and PFBMs, could also influence survival, although further studies are needed.

Details

Title
Volumetric Modulated Arc Therapy for Radiosurgery of Brain Metastases: A Single-Center Study
Author
Sánchez-Villalobos, José Manuel 1   VIAFID ORCID Logo  ; Serna-Berna, Alfredo 2 ; Salinas-Ramos, Juan 3   VIAFID ORCID Logo  ; Pedro Pablo Escolar-Pérez 3 ; Andreu-Gálvez, Marina 4 ; Martínez-Alonso, Emma 5 ; Pérez-Vicente, José Antonio 6 ; Alcaraz, Miguel 7   VIAFID ORCID Logo 

 Department of Neurology, University Hospital Complex of Cartagena, 30202 Cartagena, Murcia, Spain; [email protected]; Department of Cell Biology and Histology, School of Medicine, Regional Campus of International Excellence, “Campus Mare Nostrum”, IMIB-Pascual Parrilla, University of Murcia, 30100 Murcia, Spain; [email protected] 
 Department of Medical Physics and Radiation Protection, University Hospital Complex of Cartagena, 30202 Cartagena, Murcia, Spain; [email protected] 
 Department of Radiation Oncology, University Hospital Complex of Cartagena, 30202 Cartagena, Murcia, Spain; [email protected] (J.S.-R.); [email protected] (P.P.E.-P.) 
 Department of Otorhinolaryngology, Head and Neck Surgery, Reina Sofia University Hospital, 30003 Murcia, Spain; [email protected]; Department of Radiology and Physical Medicine, School of Medicine, Regional Campus of International Excellence, “Campus Mare Nostrum”, IMIB-Pascual Parrilla, University of Murcia, 30100 Murcia, Spain 
 Department of Cell Biology and Histology, School of Medicine, Regional Campus of International Excellence, “Campus Mare Nostrum”, IMIB-Pascual Parrilla, University of Murcia, 30100 Murcia, Spain; [email protected] 
 Department of Neurology, University Hospital Complex of Cartagena, 30202 Cartagena, Murcia, Spain; [email protected] 
 Department of Radiology and Physical Medicine, School of Medicine, Regional Campus of International Excellence, “Campus Mare Nostrum”, IMIB-Pascual Parrilla, University of Murcia, 30100 Murcia, Spain 
First page
10097
Publication year
2023
Publication date
2023
Publisher
MDPI AG
e-ISSN
20763417
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2869236924
Copyright
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.