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- Title
Hypofractionated stereotactic radiotherapy for treatment of brain tumours: an institutional experience.
- Authors
Maiya, V. M.; Bhanage, A.; Vatyam, S.; Basu, S.; Vhora, S.
- Abstract
Purpose: Hypofractionated stereotactic radiotherapy (SRT) has been recognised as a non-invasive alternative to stereotacic radiosurgery (SRS) for treating brain tumours. There is a radiobiologic advantage of fractionated treatment on sensitive structures in the brain. Non-invasive thermoplastic masks are used to allow for stereotactic delivery without the need for repeated invasive head frame applications. Such systems were found to provide accuracy equivalent to that of single-fraction systems, while providing protection of eloquent structures. Larger tumours can also be treated to curative doses. We started SRS and SRT in 2006. We have analysed our data on hypofractionated SRT. Methods: Between January 2007 to December 2011, we have treated 49 lesions in 38 patients with hypofractionated SRT. All patients underwent immobilization using Brainlab's thermoplastic face masks. Planning CT was done using localizer box. MRI was done and fused with the CT images. Contouring and planning was done on Brainlab's Iplan software. Patients were treated on SIEMENS Oncor Impression plus linac using Moduleaf microMLC. The leaf thickness of the microMLC is 2.5mm. The patients were followed up regularly both clinically and radiologically. Results: 49 lesions were treated in 38 patients. The lesions treated were metastasis (14), vestibular schwannomas (14), meningiomas (14), pituitary adenomas (3), gliomas (2), and others (1 glomus tumour and 1 pinelocytoma). 13 (26.5%) lesions were re-irradiated. The mean volume of PTV treated was 25.03 cc. The dose varied from 16 Gy to 37.5 Gy in 4 to 16 fractions. 25 Gy in 5 fractions (51%) was the commonest schedule used. 2 patients developed immediate post treatment raised intracranial pressure and were managed accordingly. 12.7 months was the mean follow-up. On follow up, 2 patients with brain metastasis died because of progressive systemic disease. 2 patients developed radiation necrosis. 5 patients had clinical and radiological progression of disease. 30 (79%) lesions were status quo or had regressed radiologically. Conclusion: Hypofractionated SRT is a feasible option for treating brain tumours. The immediate and late complications are minimal. Subset analysis showed that schwannomas responded better. This is a good treatment modality for selected group of patients. Long term follow up is required for further analysis. Disclosure: No significant relationships.
- Subjects
BRAIN tumor treatment; STEREOTACTIC radiotherapy; STEREOTACTIC radiosurgery; RADIOBIOLOGY research; PHYSIOLOGICAL effects of radiation
- Publication
Journal of Radiosurgery & SBRT, 2013, Vol 2, p80
- ISSN
2156-4639
- Publication type
Article