Features stereotactic radiosurgical treatment large brain metastatic lesions of the brain with hypoxic radiosensitizers
DOI:
https://doi.org/10.25305/unj.61885Keywords:
large brain metastases, radiosurgery, hypoxic radiosensitizers, early response to treatment, local control, survivalAbstract
Objective: Follow the dynamics of early reduction of tumor volume after stereotactic radiosurgery using hypoxic radiosensitizers and without radiosensitization, a comparison of these data with predictor of prolonged local control and median follow-up.
Materials and methods: 107 patients (173 lesions) with large brain metastases (≥10cm3) accounted for the main and control group of our research. Of these, the basic group (with radiosensitizers) 77 included, in the control group — 30 patients. Of the 77 patients, 40 patients (66 lesions) was used as a radiosensitizer metronidazole (M+), 37 (60 lesions) — nimorazol (H+).
The average volume of metastases was 20.0cm3 (range 10–60.0cm3). SRS in one fraction to the average dose of 14 Gy (range 10–18 Gy), conducted an average of 4 fractions (range 3–5 fractions), with a mean dose of 26.5 Gy (range 21–40 Gy).
Are taken into account only those patients who have at least passed the first compulsory MRI investigation a week after the SRS, with a further observation of 1.5 and 3 months.
Results: During the term of supervision in metastases which considerably diminished in a volume already in a week after SRS, the signs of local control and median follow-up, unlike a control group, without of radiosensitizers at which it was not marked early and rapid reduction of tumour (r = .003, OR = 0.424; 95% confidence interval, 0.203-0.935), also in a group with radiosensitization the indexes of survivability were higher (19.0 months against 10.0, 95% [CI], 12.876-22.124 and 7.330-12.670, р=.0008 аnd р=.0001, respectively).
Conclusions: Early reduction large brain metastases week after radiosurgery using hypoxic radiosensitizers may be a predictor of long-term local tumor control.
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