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Article Dans Une Revue British Journal of Radiology Année : 2024

The dosimetric parameters impact on local recurrence in stereotactic radiotherapy for brain metastases

Résumé

Objectives: Stereotactic radiotherapy (SRT) for brain metastases (BM) allows very good local control (LC). However, approximately 20 to 30% of these lesions will recur. The objective of this retrospective study was to evaluate the impact of dosimetric parameters on LC in cerebral SRT. Methods: Patients treated with SRT for 1-3 BM between January 2015 and December 2018 were retrospectively included. A total of 349 patients with 538 lesions were included. The median gross tumor volume (GTV) was 2 cm3 (IQR, 0-7). The median biological effective dose with α/β = 10 (BED10) was 60 Gy (IQR, 32-82). The median prescription isodose was 71% (IQR, 70-80). Correlations with LC were examined using the Cox regression model. Results: The median follow-up period was 55 months (min-max, 7-85). Median overall survival was 17.8 months (IQR, 15.2-21.9). There were 95 recurrences and LC at 1 and 2 years was 87.1% (95% CI, 84-90) and 78.1% (95% CI, 73.9-82.4), respectively. Univariate analysis showed that systemic treatment, dose to 2% and 50% of the planning target volume (PTV), BED10 > 50 Gy, and low PTV and GTV volume were significantly correlated with better LC. In the multivariate analysis, GTV volume, isodose, and BED10 were significantly associated with LC. Conclusion: These results show the importance of a BED10 > 50 Gy associated with a prescription isodose <80% to optimize LC during SRT for BM.
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Dates et versions

hal-04477662 , version 1 (26-02-2024)

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Camille Berthet, François Lucia, Vincent Bourbonne, Ulrike Schick, Isabelle Lecouillard, et al.. The dosimetric parameters impact on local recurrence in stereotactic radiotherapy for brain metastases. British Journal of Radiology, 2024, British Journal of Radiology, ⟨10.1093/bjr/tqae029⟩. ⟨hal-04477662⟩
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