Article Dans Une Revue Cancer/Radiothérapie Année : 2024

Preoperative stereotactic radiotherapy for the management of brain metastases

Florent Guillemin
  • Fonction : Auteur
Julie Villa
  • Fonction : Auteur
Gilles Truc
  • Fonction : Auteur
Delphine Antoni
  • Fonction : Auteur
Clara Le Fèvre
  • Fonction : Auteur
François Thillays
  • Fonction : Auteur

Résumé

Traditionally, postoperative whole-brain radiation therapy (WBRT) has been used for resected brain metastases, reducing local and intracerebral relapses. However, WBRT is associated with cognitive deterioration. Postoperative stereotactic radiotherapy (SRT) has emerged due to its neurocognitive preservation benefits. Despite its advantages, postoperative SRT has several drawbacks, including difficulties in target volume delineation, increased risk of radionecrosis (RN) and leptomeningeal disease (LMD), and prolonged treatment duration. Preoperative SRT has been proposed as a potential alternative, offering promising results in retrospective studies. Retrospective studies have suggested that preoperative SRT could achieve high local control rates with fewer LMD and RN rates compared to postoperative SRT. However, preoperative SRT is primarily based on retrospective data, and no phase 2/3 trials have been published to date. Ongoing clinical trials are expected to provide further insights into the efficacy and safety of preoperative SRT, addressing key questions regarding fractionation, dose, and timing relative to surgery.

Dates et versions

hal-04920836 , version 1 (30-01-2025)

Identifiants

Citer

Julian Biau, Florent Guillemin, Angeline Ginzac, Julie Villa, Gilles Truc, et al.. Preoperative stereotactic radiotherapy for the management of brain metastases. Cancer/Radiothérapie, 2024, 28 (6-7), pp.534-537. ⟨10.1016/j.canrad.2024.07.006⟩. ⟨hal-04920836⟩
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