RT Journal Article
SR Electronic
T1 Staged Stereotactic Radiosurgery Decreases Symptomatic Radionecrosis in Large Brain Metastasis
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 1445
OP 1449
DO 10.21873/anticanres.14902
VO 41
IS 3
A1 NEIL CHEVLI
A1 HUI-CHUAN WANG
A1 PRACHI DUBEY
A1 WAQAR HAQUE
A1 ANDREW M. FARACH
A1 RAMIRO PINO
A1 ROBERT C. ROSTOMILY
A1 E. BRIAN BUTLER
A1 BIN S. TEH
YR 2021
UL http://ar.iiarjournals.org/content/41/3/1445.abstract
AB Background: Limited brain metastasis is treated definitively with stereotactic radiosurgery when surgical resection is not indicated. Although this has historically been performed in a single fraction, multi-fraction approaches such as fraction radiosurgery (FSRS) and staged radiosurgery (SSRS) have been recently examined as alternative approaches for larger lesions to permit better tumor control without increased toxicity. Case Report: We present the case of a patient who developed symptomatic radionecrosis in two brain metastasis, 2.3 cm and 2.1 cm in size, which were treated with 18 Gy in one fraction, but no radionecrosis in a 3.3 cm lesion treated in two fractions of 15 Gy nor in two punctate lesions that were treated in one fraction of 20 Gy. Although she did not respond to steroids, she responded to bevacizumab symptomatically and on neuroimaging. Conclusion: Congruent with other recent studies, our report suggests that large brain metastasis should be considered for FSRS/SSRS.