> Detailanzeige

El-Shafie, Rami [VerfasserIn]; Tonndorf-Martini, Eric [VerfasserIn]; Schmitt, Daniela [VerfasserIn]; Kronsteiner, Dorothea [VerfasserIn]; Celik, Aylin [VerfasserIn]; Dresel, Thorsten [VerfasserIn]; Bernhardt, Denise [VerfasserIn]; Lang, Kristin [VerfasserIn]; Hoegen, Philipp [VerfasserIn]; Adeberg, Sebastian [VerfasserIn]; Paul, Angela [VerfasserIn]; Debus, Jürgen [VerfasserIn]; Rieken, Stefan [VerfasserIn]

Pre-operative versus post-operative radiosurgery of brain metastases - volumetric and dosimetric impact of treatment sequence and margin concept

Literatur-
verwaltung

Zur
Merkliste

Lösche von
Merkliste

Per Whatsapp teilen

Schließen

Merkliste



Sie können Bookmarks mittels Listen verwalten, loggen Sie sich dafür bitte in Ihr SLUB Benutzerkonto ein.
  • Medientyp: E-Artikel
  • Titel: Pre-operative versus post-operative radiosurgery of brain metastases - volumetric and dosimetric impact of treatment sequence and margin concept
  • Beteiligte: El-Shafie, Rami [VerfasserIn]; Tonndorf-Martini, Eric [VerfasserIn]; Schmitt, Daniela [VerfasserIn]; Kronsteiner, Dorothea [VerfasserIn]; Celik, Aylin [VerfasserIn]; Dresel, Thorsten [VerfasserIn]; Bernhardt, Denise [VerfasserIn]; Lang, Kristin [VerfasserIn]; Hoegen, Philipp [VerfasserIn]; Adeberg, Sebastian [VerfasserIn]; Paul, Angela [VerfasserIn]; Debus, Jürgen [VerfasserIn]; Rieken, Stefan [VerfasserIn]
  • Erschienen: 1 March 2019
  • Erschienen in: Cancers ; 11(2019,3) Artikel-Nummer 294, 18 Seiten
  • Sprache: Englisch
  • DOI: 10.3390/cancers11030294
  • ISSN: 2072-6694
  • Identifikator:
  • Schlagwörter: metastases ; neurosurgery ; radiation therapy ; radiosurgery ; radiotherapy ; stereotactic ; tumor
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: Background: Pre-operative radiosurgery (SRS) preceding the resection of brain metastases promises to circumvent limitations of post-operative cavity SRS. It minimizes uncertainties regarding delineation and safety margins and could reduce dose exposure of the healthy brain (HB). Methods: We performed a systematic treatment plan comparison on 24 patients who received post-operative radiosurgery of the resection cavity at our institution. Comparative treatment plans were calculated for hypofractionated stereotactic radiotherapy (7 x 5 Gray (Gy)) in a hypothetical pre-operative (pre-op) and two post-operative scenarios, either with (extended field, post-op-E) or without the surgical tract (involved field, post-op-I). Detailed volumetric comparison of the resulting target volumes was performed, as well as dosimetric comparison focusing on targets and the HB. Results: The resection cavity was significantly smaller and different in morphology from the pre-operative lesion, yielding a low Dice Similarity Coefficient (DSC) of 53% (p = 0.019). Post-op-I and post-op-E targets showed high similarity (DSC = 93%), and including the surgical tract moderately enlarged resulting median target size (18.58 ccm vs. 22.89 ccm, p < 0.001). Dosimetric analysis favored the pre-operative treatment setting since it significantly decreased relevant dose exposure of the HB (Median volume receiving 28 Gy: 6.79 vs. 10.79 for pre-op vs. post-op-E, p < 0.001). Dosimetrically, pre-operative SRS is a promising alternative to post-operative cavity irradiation that could furthermore offer practical benefits regarding delineation and treatment planning. Comparative trials are required to evaluate potential clinical advantages of this approach.
  • Zugangsstatus: Freier Zugang