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Medicina
Special Issues
Radiotherapy for Brain Metastasis and Long-Term Survival
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Radiotherapy for Brain Metastasis and Long-Term Survival

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (29 February 2024) | Viewed by 1058

Special Issue Editors

Dr. Antonio Pontoriero

E-Mail Website
Guest Editor
Radiotherapy Unit, University of Messina, Messina, Italy
Interests: CyberKnife; radiosurgery; SBRT; FSRT; radiotherapy
Special Issues, Collections and Topics in MDPI journals
Dr. Alfredo Conti

E-Mail Website
Guest Editor
Unit of Neurosurgery, IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy
Interests: neurosurgery; CyberKnife; radiosurgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Patients with brain metastases can benefit from radiotherapy, although the long‐term benefits of radiotherapy remain unclear. Stereotactic radiosurgery (SRS) improves the local control of brain metastases. Furthermore, the QUARTZ trial revealed that whole-brain radiotherapy (WBRT) provides limited benefits, relative to best supportive care alone, for patients with brain metastases from non-small cell lung cancer. The literature data revealed that poor overall survival after WBRT was associated with poor performance status, older age, >3 intracranial metastases, and uncontrolled primary tumors. Based on these conflicting findings, questions have emerged regarding the benefits of radiotherapy for brain metastases that were determined based on previous clinical studies. The combined evidence suggests that WBRT offers no substantial benefit to most patients with brain metastases from lung cancer in terms of improved survival, overall quality of life, or reduction in steroid use. The implication for clinical care is that optimal supportive care is as effective as supportive care plus WBRT, and the implication for future research is that potential new treatments could be assessed in addition to supportive care, rather than in addition to, or in place of, WBRT. Given the lack of long-term analyses of the benefits of radiotherapy in this setting, it is necessary to compare the long-term results of radiotherapy for brain metastases.

Therefore, we encourage authors to submit their original research articles, reviews, systematic reviews, case reports, clinical outcome studies or new surgical techniques and oncological therapies regarding this subject.

Dr. Antonio Pontoriero
Dr. Alfredo Conti
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

 

Keywords

  • whole-brain irradiation
  • stereotactic radiosurgery
  • brain metastasis
  • median survival
  • risk factor and long-term survival

Published Papers (1 paper)

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Research

12 pages, 1917 KiB  
Article
Assessment of Radiation Dosage to the Hippocampi during Treatment of Multiple Brain Metastases Using Gamma Knife Therapy
by Maciej Laskowski, Bartłomiej Błaszczyk, Marcin Setlak, Maciej Kuca, Arkadiusz Lech, Kamil Kłos and Adam Rudnik
Medicina 2024, 60(2), 246; https://doi.org/10.3390/medicina60020246 - 31 Jan 2024
Viewed by 761
Abstract
Background and Objectives: Brain metastases (BMs) pose significant clinical challenges in systemic cancer patients. They often cause symptoms related to brain compression and are typically managed with multimodal therapies, such as surgery, chemotherapy, whole brain radiotherapy (WBRT), and stereotactic radiosurgery (SRS). With modern [...] Read more.
Background and Objectives: Brain metastases (BMs) pose significant clinical challenges in systemic cancer patients. They often cause symptoms related to brain compression and are typically managed with multimodal therapies, such as surgery, chemotherapy, whole brain radiotherapy (WBRT), and stereotactic radiosurgery (SRS). With modern oncology treatments prolonging survival, concerns about the neurocognitive side effects of BM treatments are growing. WBRT, though widely used for multiple BMs, has recognized neurocognitive toxicity. SRS, particularly Gamma Knife (GK) therapy, offers a minimally invasive alternative with fewer side effects, suitable for patients with a quantifiable number of metastases and better prognoses. Materials and Methods: A retrospective analysis was conducted on 94 patients with multiple BMs treated exclusively with GK at an academic medical center. Patients with prior WBRT were excluded. This study focused on the mean radiation dose received by the hippocampal area, estimated according to the ‘Hippocampal Contouring: A Contouring Atlas for RTOG 0933’ guidelines. Results: The precision of GK equipment results in mean doses of radiation that are lower than those suggested by RTOG 0933 and observed in other studies. This precision may help mitigate cognitive dysfunction and other side effects of hippocampal irradiation. Conclusions: GK therapy facilitates the administration of smaller, safer radiation doses to the hippocampi, which is advantageous even for lesions in the temporal lobe. It is feasible to treat multiple metastases, including cases with more than 10, but it is typically reserved for patients with fewer metastases, with an average of 3 in this study. This underlines GK’s potential for reducing adverse effects while managing BMs effectively. Full article
(This article belongs to the Special Issue Radiotherapy for Brain Metastasis and Long-Term Survival)
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