Linac-Based Fractionated Stereotactic Radiotherapy with a Micro-Multileaf Collimator for Brainstem Metastasis.

• Material Type: 博士論文
• Title: Linac-Based Fractionated Stereotactic Radiotherapy with a Micro-Multileaf Collimator for Brainstem Metastasis.
• Author/Editor: Sugimoto, Tadashi; Matsuda, Ryosuke; Tamamoto, Tetsuro; Hontsu, Shigeto; Yamaki, Kaori; Miura, Sachiko; Park, Young-Su; Nakase, Hiroyuki; Hasegawa, Masatoshi
• Author Heading: Sugimoto, Tadashi; Matsuda, Ryosuke; Tamamoto, Tetsuro; Hontsu, Shigeto; Yamaki, Kaori; Miura, Sachiko; Park, Young-Su; Nakase, Hiroyuki; Hasegawa, Masatoshi
• Publication, Distribution, etc.: Elsevier
• Publication Date: 2019-12
• Publication Date (W3CDTF): 2019-12
• Alternative Title: 脳幹部転移性脳腫瘍に対する寡分割定位放射線治療の治療成績
• Periodical title: World neurosurgery
• No. or year of volume/issue: 132
• Volume: 132
• Pages: e680-e686
• ISSN (Periodical Title): ISSN : 1878-8750
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2020-03-16
• Dissertation Number: 乙第1450号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Brainstem metastasis; Fractionated radiotherapy; Novalis; Stereotactic radiotherapy
• Target Audience: 一般
• Note (General): type:Thesis; Background: To assess the neuroimaging and clinical outcomes in patients with brainstem metastasis (BSM) treated with linac-based fractionated stereotactic radiotherapy (fSRT) with a micro-multileaf collimator. Methods: Between May 2007 and January 2017, 24 patients (15 male and 9 female) with BSM (25 lesions: midbrain, 10; pons, 13; and medulla oblongata, 2) were consecutively treated with linac-based fSRT. BSM originated from the lung (n = 18, 75.0%), colon (n = 3, 12.5%), and breast (n = 3, 12.5%). The median patient age was 67.0 (range: 42-80) years. Recursive partition analysis classified 2 patients as class I, 17 as class II, and 5 as class III. Overall survival was calculated using the Kaplan-Meier method. Results: Tumor volume ranged from 0.01 to 7.49 cm3 (median: 0.233 cm3), and patients were treated with a dose of 24-40 Gy in 7-13 fractions. The median OS was 9 months after fSRT (95% confidence interval 4.104-13.896). Large tumor volume, presence of brainstem-related symptoms, poor pretreatment Karnofsky performance status, and recursive partition analysis class III were significantly associated with low overall survival. Tumor volume decreased in 18 metastatic lesions, remained stable in 6, and increased in 1. No patient exhibited permanent radiation injury. Grade 2 nausea and vomiting according to the Common Terminology Criteria for Adverse Events 4.0 occurred in 1 patient who received corticosteroids. Conclusions: Linac-based fSRT with a micro-multileaf collimator delivered in the doses of 24-40 Gy in 7-13 fractions is a safe and effective local therapy for patients with BSM.; 博士（医学）・乙第1450号・令和2年3月16日; Copyright © 2019 Elsevier Inc. All rights reserved.; identifier:World neurosurgery Vol.132 p.e680-e686 (2019 Dec); identifier:18788750; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3740; identifier:World neurosurgery, 132: e680-e686
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1016/j.wneu.2019.08.049
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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