Recurrent Disease
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Recurrent Central Nervous System (CNS) lesions:
Post-radiotherapy primary CNS tumor recurrences (38,39) and recurrent brain metastases (40) have been safely retreated with radiosurgery (38,40) or fractionated stereotactic radiotherapy (39). In the case of recurrent gliomas, median survival extensions of 7 and 7.8 months have been reported with single fraction radiosurgery and fractionated stereotactic radiotherapy, respectively, with no significant complications, and occasional long-term survivals in patients with small volume recurrences (38,39). The retreatment result has been more durable with linac-based radiosurgery for brain metastases, with an 84% rate of local control 2 years following radiosurgical retreatment (40). In the case of metastatic lesions, the 84% 2 year local control rate and 57% overall brain disease-free rate appears to significantly exceed the result reported with standard radiotherapy retreatment (11).
Post-radiotherapy primary CNS tumor recurrences (38,39) and recurrent brain metastases (40) have been safely retreated with radiosurgery (38,40) or fractionated stereotactic radiotherapy (39). In the case of recurrent gliomas, median survival extensions of 7 and 7.8 months have been reported with single fraction radiosurgery and fractionated stereotactic radiotherapy, respectively, with no significant complications, and occasional long-term survivals in patients with small volume recurrences (38,39). The retreatment result has been more durable with linac-based radiosurgery for brain metastases, with an 84% rate of local control 2 years following radiosurgical retreatment (40). In the case of metastatic lesions, the 84% 2 year local control rate and 57% overall brain disease-free rate appears to significantly exceed the result reported with standard radiotherapy retreatment (11).
Image adapted from"Robotic Radiosurgery" - First Edition
Written by Donald B. Fuller, M.D. – Radiation Oncologist