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Localized Field External Beam Radiation Therapy after Metastasectomy of Solitary Brain Lesion

Aim: Evaluation of local control-fee survival, distant failure-free survival of patients treated with surgical excision and localized field radiation therapy.
Background: Localized surgical excision of solitary brain metastasis followed by adjuvant localized fractionated radiation therapy reduce irradiation of normal brain tissue and consecutively reduce late effects.
Methods: From January 2011 to April 2015, 31 patients with single brain metastasis underwent surgical resection followed by involved field radiation therapy; local recurrence (LR) free survival, distant failure (DF) free survival and overall survival (OS) were estimated and correlated with clinical variables. Salvage therapy and toxicity were assessed.
Results: For the whole cohort, the median follow up was 18 months, and the LR-free survival was 89.4%, DF-free survival and OS at 12 months was 72% 86.4% respectively. No clinical factors were associated with local recurrence in univariate analysis; however, primary tumor and tentorial relation were associated with distant failure in univariate analysis. RPA class was associated with overall survival. LRs were salvaged in four out of five patients and DFs were salvaged in ten out twelve patients. Radionecrosis was reported in only one case.
Conclusions: Localized field radiation therapy after surgical excision of solitary brain metastasis in well selected patients with controlled primary and metastatic disease has acceptable local control rates and toxicity.


El-Aziz Ghannam AA, El-Ghany Khedr RA, Ibrahim MF and Ganna AA

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