Frameless LINAC based stereotactic radiotherapy to brain metastasis resection cavity without whole brain radiotherapy

: A systematic review

via Practical Radiation Oncology

Source:Practical Radiation Oncology
Author(s): Orit Kaidar-Person, Timothy M. Zagar, Matthew Ewend, Tzahala Tzuk-Shina, Lawrence B. Marks
The aim of this systematic review was to summarize the findings from the published data of frameless stereotactic radiotherapy to the resection cavity delivered with non- robotic – linear accelerator in patients with brain metastases.MethodsThe studies cited in this systematic review were identified through a search of the PubMed database, using the search terms: "stereotactic [Title/Abstract]" and "Brain [Title/Abstract]" and "Metas* [Title/Abstract] ". The search was unlimited to language and publication year.ResultsA total of 9 studies were included in our review. Stereotactic radiotherapy to the resection cavity appears to provide excellent local control rates that are comparable to framed stereotactic radiotherapy. There are various factors that influence local control. Distant intracranial control rates are poor with the use of postoperative stereotactic radiotherapy compared to local treatment (surgery or stereotactic radiotherapy) plus whole brain radiotherapy.Discussion/ConclusionsStereotactic radiotherapy to the resection cavity appears to provide good local control rates and poor distant intracranial control. Postoperative treatment should be discussed by a multidisciplinary team and tailored to each case individually.

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