Description of brain metastasis response and adverse effects to CyberKnife® treatment

Authors

  • Ana Teresa Araujo-Reyes University of Antioquia https://orcid.org/0000-0003-0962-7945
  • José Luis Ascencio-Lancheros Neurological Institute of Colombia
  • Ana Londoño-Álvarez Neurological Institute of Colombia

DOI:

https://doi.org/10.17533/udea.iatreia.55

Keywords:

cerebrum, metastases, radiosurgery

Abstract

Background: Cancer´s first cause of death are metastases. Mean survival for untreated patients is 3 months, which can extend to six or twelve months with conventional radiotherapy or chemotherapy, depending on the tumor. Stereotactic radiosurgery is a method which aims an ionizing radiation dose towards an intracranial target, guided by computarized tomography or magnetic resonance, reducing radiation on healthy brain tissue, as well as adverse effects. Its main indication is to achieve tumor control in patients with oligometastases.

Methods: Retrospective, observational study, with primary and secondary sources for data, for describing results of CyberKnife® treatment.

Results: Data were available for 31 patients and 62 metastases. Mean age was 54 years, 74,19 % were women. Lung cancer was the most frequent primary tumor (54,8 %); half of the cases had more than two metastases; most common location was frontal lobes (33,9 %), being 48,4 % of the tumors morphologically necrotic. There was a previous treatment in 69,4 % of the tumors. There was radionecrosis in 19,4 % of the metastases, vasogenic edema in 77,4% of them and relapses in 59,7 % of the tumors. Tumor size was reduced in 80,7 % of the metastases and tumor control was achieved in 83,9 % of them.

Conclusions: CyberKnife® was able to achieve control in at least four-fifths of the treated metastases, with a relevant influence of metastases´ location in central nervous and an acceptable prevalence of radionecrosis as a complication.

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Author Biographies

Ana Teresa Araujo-Reyes, University of Antioquia

Resident of Neuroradiology.

José Luis Ascencio-Lancheros, Neurological Institute of Colombia

Neuroradiologist.

Ana Londoño-Álvarez, Neurological Institute of Colombia

Neurologist.

References

(1) Langley RR, Fidler IJ. The biology of brain metastasis: Challenges for Therapy. Clin Chem. 2013;59(1):180-9. DOI 10.1373/clinchem.2012.193342.

(2) Nathoo M, Chahlavi A, Barnett GH, Toms SA. Pathobiology of brain metastases. J Clin Pathol. 2005;58(3):237-42. DOI 10.1136/jcp.2003.013623.

(3) Kamar FG, Posner JB. Brain metastases. Semin Neurol. 2010;30(3):217-35. DOI 10.1055/s-0030-1255225.

(4) Shah N, Mohammad AS, Saralkar P, Sprowls SA, Vickers SD, John D, et al. Investigational chemotherapy and novel pharmacokinetic mechanisms for the treatment of breast cancer brain metastases. Pharmacol Res. 2018;132:47-68. DOI 10.1016/j.phrs.2018.03.021.

(5) Steeg PS, Camphausen KA, Smith QR. Brain metastases as preventive and therapeutic targets. Nat Rev Cancer. 2011;11(5):352-63. DOI 10.1038/nrc3053.

(6) Shmueli E, Wigler N, Inbar M. Central nervous system progression among patients with metastatic breast cancer responding to trastuzumab treatment. Eur J Cancer. 2004;40(3):379-82. DOI 0.1016/j.ejca.2003.09.018.

(7) Matzenauer M, Vrana D, Melichar B. Treatment of brain metastases. Biomed Pap. 2016;160(4):484-90. DOI 10.5507/bp.2016.058.

(8) Lam WKJ, Chan JYK. Recent advances in the management of nasopharyngeal carcinoma. F1000Res. 2018;7(0). DOI 10.12688/f1000research.15066.1.

(9) SEOR. Manual Práctocp de oncología Radioterápica. España: SEOR; 2013.

(10) Patel A, Dong T, Ansari S, Cohen-Gadol A, Watson GA, Moraes FY de, et al. Toxicity of Radiosurgery for Brainstem Metastases. World Neurosurg. 2018;119:e757-64. DOI 10.1016/j.wneu.2018.07.263.

(11) Sparacia G, Agnello F, Banco A, Bencivinni F, Anastasi A, Giordano G, et al. Value of serial magnetic resonance

imaging in the assessment of brain metastases volume control during stereotactic radiosurgery. World J Radiol. 2016Dec 28;8(12):916-21. DOI 10.4329/wjr.v8.i12.916.

(12) Sharpton SR, Oermann EK, Moore DT, Schreiber E, Hoffman R, Morris DE, et al. The volumetric response of brain metastases after stereotactic radiosurgery and its post-treatment implications. Neurosurgery. 2014;74(1):9-15. DOI 10.1227/NEU.0000000000000190.

(13) Aiyama H, Yamamoto M, Kawabe T, Watanabe S, Koiso T, Sato Y, et al. Complications after stereotactic radiosurgery for brain metastases: Incidences, correlating factors, treatments and outcomes. Radiother Oncol. 2018;129(2):364-9. DOI 10.1016/j.radonc.2018.08.018.

(14) Liu Q, Yuan HY, Xia K, Yuan Z. Stereotactic radiosurgery (SRS) in the modern management of patients with brain metastases. Oncotarget.2016;7(11). DOI 10.18632/oncotarget.7131.

(15) Lippitz B, Lindquist C, Paddick I, Peterson D, O’Neill K, Beaney R. Stereotactic radiosurgery in the treatment of brain metastases: The current evidence. Cancer Treat Rev. 2014;40(1):48-59. DOI 10.1016/j.ctrv.2013.05.002.

(16) Linskey ME, Andrews DW, Asher AL, Burri SH, Kondziolka D, Robinson PD, et al. The role of stereotactic radiosurgery in the management of patients with newly diagnosed brain metastases: A systematic review and evidence-based clinical practice guideline. J Neurooncol. 2010;96(1):45-68. DOI 10.1007/s11060-009-0073-4.

(17) Velnar T, Bosnjak R. Radiosurgical techniques for the treatment of brain neoplasms: A short review. World J Methodol. 2018 Dec 14;8(4):51-58. DOI 10.5662/wjm.v8.i4.51.

(18) JayaraoM, Chin LS. Robotics and its applications in stereotactic radiosurgery. Neurosurg Focus. 2007;23(6):E5.

DOI 10.3171/FOC-07/12/E6.

(19) Chang SD, Murphy M, Geis P, Martin DP, Hancock SL, Doty JR, et al. Radiosurgery (the Cyberknife) in the Treatment of Brain and Spinal Cord Tumors. Neurol Med Chir. 1998;38:780-3. DOI 10.2176/nmc.38.780.

(20) Kim YS. Cyberknife robotic radiosurgery system for cancer treatment. J Korean Med Assoc. 2008;51(7):630-7. DOI 10.5124/jkma.2008.51.7.630.

(21) Gibbs IC. Frameless image-guided intracranial and extracranial radiosurgery using theCyberknifeTMrobotic

system. Cancer Radiother. 2006;10(5):283-7. DOI 10.1016/j.canrad.2006.05.013.

(22) ElaimyAL, MacKay AR, Lamoreaux WT, Fairbanks RK, Demakas JJ, Cooke BS, et al. Clinical outcomes of stereotactic radiosurgery in the treatment of patients with metastatic brain tumors. World Neurosurg. 2011;75(5-6):673-83. DOI 10.1016/j.wneu.2010.12.006.

(23) Rades D, Pluemer A, Veninga T, Schild SE. Comparison of different treatment approaches for one to two brain metastases in elderly patients. Strahlenther Onkol. 2008;184(11):565-71. DOI 10.1007/s00066-008-1908-1.

(24) Müller-Riemenschneider F, Bockelbrink A, Ernst I, Schwarzbach C, Vauth C, von der Schulenburg JMG, et al. Stereotactic radiosurgery for the treatment of brain metastases. Radiother Oncol. 2009;91(1):67-74. DOI 10.1016/j.radonc.2008.12.001.

(25) O’Beirn M, Benghiat H, Meade S, Heyes G, Sawlani V, Kong A, et al. The Expanding Role of Radiosurgery for Brain Metastases. Medicines. 2018;5(3):90. DOI 10.3390/medicines5030090.

(26) Patel TR, McHugh BJ, Bi WL, Minja FJ, Knisely JPS, Chiang VL. A comprehensive review of MR imaging changes following radiosurgery to 500 brain metastases. Am J Neuroradiol. 2011;32(10):1885-92. DOI 10.3174/ajnr.A2668.

(27) Wang ZZ, Yuan ZY, Zhang WC, You JQ, Wang P. Brain metastasis treated with cyberknife. Chin Med J (Engl). 2009;122(16):1847-50.

(28) Nishizaki T, Saito K, Jimi Y, Harada N, Kajiwara K, Nomura S, et al. The role of cyberknife radiosurgery/radiotherapy for brain metastases of multiple or large-size tumors. Minim Invasive Neurosurg. 2006Aug;49(4):203-9. DOI 10.1055/s-2006-947998.

(29) Hara W, Tran P, Li G, Su Z, Puataweepong P, Adler JR, et al. CyberKnife for brain metastases of malignant melanoma and renal cell carcinoma. Neurosurgery. 2009;64(2 SUPPL.):26-32. DOI 10.1227/01.NEU.0000339118.55334.EA.

(30) Poblete Poulsen T, Donoso C MT, Holzer MF. Caracterización de pacientes operados de metástasis cerebral en el Instituto de Neurocirugía Asenjo (INCA). Rev Chil Neuro-Psiquiatr. 2008;46(2):101-6. DOI 10.4067/S0717-92272008000200003.

(31) Nichol A, Ma R, Hsu F, Gondara L, Carolan H, Olson R, et al. Volumetric Radiosurgery for 1 to 10 Brain Metastases: A Multicenter, Single-Arm, Phase 2 Study. Int J Radiat Oncol Biol Phys. 2016;94(2):312-21. DOI 10.1016/j.ijrobp.2015.10.017.

(32) Le Rhun E, Dhermain F, Vogin G, Reyns N, Metellus P. Radionecrosis after stereotactic radiotherapy for brain metastases. Expert Rev Neurother. 2016;16(8):903-14. DOI 10.1080/14737175.2016.1184572.

Published

2020-04-03

How to Cite

1.
Araujo-Reyes AT, Ascencio-Lancheros JL, Londoño-Álvarez A. Description of brain metastasis response and adverse effects to CyberKnife® treatment. Iatreia [Internet]. 2020 Apr. 3 [cited 2025 Jan. 22];33(4):324-32. Available from: https://revistas.udea.edu.co/index.php/iatreia/article/view/338625

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Section

Original research