Linear accelerator-based radiosurgery and hypofractionated stereotactic radiotherapy for brain metastasis secondary to gynecologic malignancies: A single institution series examining outcomes of a rare entity

摘要

Objective The use of SRS and fSRT to determine overall survival, tumor control, and local-disease free progression in patient diagnosed with gynecologic brain metastasis. Methods In this retrospective review, 11 patients aged 50 to 85 (median age of 71) were treated with linear accelerator-based SRS and hypofractionated SRT for brain metastasis secondary to gynecologic malignancies. In total, 16 tumors were treated from 2007 to 2017. Patients were treated to a median dose of 24?Gy (range 15 to 30?Gy) in 3 Fx (range 1 to 5). Median follow-up from SRS or SRT was 4?months (range 3–38?months). Results The actuarial 1-year overall survival rate was 26% with a median overall survival of 8?months. In addition, 1-year actuarial local control rate was 83.3% and the 1-year distant brain control rate was 31%. One patient experienced toxicity that presented as seizures after 7?months (due to minimal edema) that required anticonvulsants. There was no other acute or late treatment-related toxicity. Conclusion: Linear-accelerator based SRS or fSRT is safe and effective for control of local tumor growth in brain metastases secondary to gynecologic malignancies. The course of disease remains aggressive as seen by poor overall survival and distant failure rate. Highlights ? Brain Metastases as a result of gynecologic malignancies are rare, making up <3% of CNS metastasis. ? Improved systemic treatment and radiographic sensitivity has led to increased incidence of gynecologic brain metastasis. ? Stereotactic technique, including radiosurgery and radiotherapy, remain a safe, effective treatment option.