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首页> 外文期刊>Journal of neuro-oncology. >Clinical outcomes for a novel 6 degrees of freedom image guided localization method for frameless radiosurgery for intracranial brain metastases
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Clinical outcomes for a novel 6 degrees of freedom image guided localization method for frameless radiosurgery for intracranial brain metastases

机译：一种新型的6自由度图像指导的颅内脑转移无框放射外科定位方法的临床结果

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Stereotactic radiosurgery (SRS) is an accepted method of treatment for intracranial brain metastases with sub-millimeter accuracy. Frameless radiosurgery (FRS) is becoming an alternative to framed SRS due to its less invasive requirements. The purpose of this study is to describe the clinical outcomes and local patterns of failure for a novel 6 degrees of freedom CT guided method of localization for FRS of intracranial brain metastases. 42 patients underwent linear accelerator-based FRS to 94 intracranial brain metastases between 01/2009 and 07/2011. 78 and 22 % of treated sites were intact metastases and resection cavities, respectively. 55 % of patients had undergone prior brain radiotherapy (45 % SRS, 26 % whole brain radiation therapy). The 1 year actuarial local recurrence rate was 18 %, with a median imaging follow-up period of 13.2 months. Single fraction equivalent dose was the most important predictor of local recurrence. The 1 year actuarial first distant brain recurrence and total intracranial recurrence rate was 58 and 69 %, respectively. The crude radiographic radiation necrosis rate was 3 %. Of the 10 local recurrence events, 8 (80 %) were in-field only, 1 (10 %) was marginal only, and 1 (10 %) was both. The preponderance of in-field only patterns of failure suggests that geographic miss is not a major contributor to local recurrence using this novel localization method for FRS. The 1 year local control rate is comparable to other similar published series of framed and frameless radiosurgery.
机译：立体定向放射外科手术（SRS）是颅内脑转移瘤的一种公认的治疗方法，其精确度低于亚毫米。无框架放射外科（FRS）由于具有较低的侵入性要求，正成为框架SRS的替代产品。这项研究的目的是描述颅内脑转移的FRS的新型6自由度CT引导定位方法的临床结果和局部失败模式。在01/2009至07/2011年之间，有42例患者接受了基于线性加速器的FRS进行94次颅内脑转移。分别有78％和22％的治疗部位是完整的转移灶和切除腔。 55％的患者曾经接受过脑部放射治疗（45％的SRS，26％的全脑放射治疗）。 1年的精算局部复发率为18％，中位影像学随访时间为13.2个月。单次当量剂量是局部复发的最重要预测指标。 1年精算首次远距脑复发和总颅内复发率分别为58％和69％。放射线照相的坏死率为3％。在这10例局部复发事件中，只有8例（80％）仅在野外发生，有1例（10％）仅在边缘发生，而1例（10％）都在现场。使用这种新颖的FRS本地化方法，仅在现场失败的模式占主导地位，这表明地理缺失不是导致局部复发的主要因素。 1年局部控制率可与其他类似的有框架和无框架放射外科手术系列相媲美。

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