Publication:
Single-fraction versus hypofractionated gamma knife radiosurgery for small metastatic brain tumors

dc.contributor.departmentKUH (Koç University Hospital)
dc.contributor.kuauthorSamancı, Mustafa Yavuz
dc.contributor.kuauthorKaraköse, Fatih
dc.contributor.kuauthorŞenyürek, Şükran
dc.contributor.kuauthorPeker, Selçuk
dc.contributor.kuprofileFaculty Member
dc.contributor.kuprofileOther
dc.contributor.kuprofileDoctor
dc.contributor.kuprofileFaculty Member
dc.contributor.yokid275252
dc.contributor.yokidN/A
dc.contributor.yokidN/A
dc.contributor.yokid11480
dc.date.accessioned2024-11-09T23:34:11Z
dc.date.issued2021
dc.description.abstractStereotactic radiosurgery (SRS) has become a standard of care for the treatment of metastatic brain tumors (METs). Although a better balance of tumor control and toxicity of hypofractionated SRS (hfSRS) compared with single-fraction SRS (sfSRS) was demonstrated in large METs, there is no data comparing two approaches for small METs (< 4 cm(3)). It was aimed to compare clinical outcomes between sfSRS versus hfSRS Gamma Knife radiosurgery (GKRS) in a series of patients with unresected, small METs. Patients (n = 208) treated with sfGKRS or hfGKRS between June 2017 and May 2020 were retrospectively examined in a single center. The co-primary endpoints of local control (LC) and toxicity were estimated by applying the Kaplan-Meier method. Multivariate analysis using Cox proportional hazards (HR) modeling was used to assess the effect of independent variables on the outcomes. The actuarial LC rate was 99.7% at six months and 98.8% at 18 months in the sfGKRS group, and 99.4% and 94.3% in the hfGKRS group (p = 0.089), respectively. In multivariate analysis, MET volume (p = 0.023, HR 2.064) and biologically effective dose (BED10) (p < 0.0001, HR 0.753) was associated with LC. In total, treatment-related toxicity was observed in 13 (8.7%) patients during a median period of 10 weeks (range 1-31). Radiation necrosis was observed in four patients (1.9%), and all patients were in the sfGKRS group (p = 0.042). Only the maximum dose was associated with toxicity (p = 0.032, HR 1.047). Our current results suggest that hfGKRS is advantageous and beneficial also in patients with unresected, small METs.
dc.description.indexedbyWoS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.issue3
dc.description.openaccessNO
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.volume38
dc.identifier.doi10.1007/s10585-021-10086-y
dc.identifier.eissn1573-7276
dc.identifier.issn0262-0898
dc.identifier.quartileQ2
dc.identifier.scopus2-s2.0-85102787199
dc.identifier.urihttp://dx.doi.org/10.1007/s10585-021-10086-y
dc.identifier.urihttps://hdl.handle.net/20.500.14288/12305
dc.identifier.wos629923000001
dc.keywordsBrain metastases
dc.keywordsFractionation
dc.keywordsGamma knife radiosurgery
dc.keywordsHypofractionated radiosurgery
dc.keywordsLocal control
dc.keywordsRadiation necrosis
dc.languageEnglish
dc.publisherSpringer
dc.sourceClinical and Experimental Metastasis
dc.subjectOncology
dc.titleSingle-fraction versus hypofractionated gamma knife radiosurgery for small metastatic brain tumors
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.authorid0000-0001-8952-6866
local.contributor.authoridN/A
local.contributor.authorid0000-0003-3010-6132
local.contributor.authorid0000-0003-3057-3355
local.contributor.kuauthorSamancı, Mustafa Yavuz
local.contributor.kuauthorKaraköse, Fatih
local.contributor.kuauthorŞenyürek, Şükran
local.contributor.kuauthorPeker, Selçuk
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit2KUH (Koç University Hospital)
relation.isOrgUnitOfPublicationf91d21f0-6b13-46ce-939a-db68e4c8d2ab
relation.isOrgUnitOfPublication.latestForDiscoveryf91d21f0-6b13-46ce-939a-db68e4c8d2ab

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