PMID- 37812290
OWN - NLM
STAT- MEDLINE
DCOM- 20231102
LR  - 20231103
IS  - 1573-7373 (Electronic)
IS  - 0167-594X (Print)
IS  - 0167-594X (Linking)
VI  - 164
IP  - 3
DP  - 2023 Sep
TI  - Intraoperative or postoperative stereotactic radiotherapy for brain metastases: 
      time to systemic treatment onset and other patient-relevant outcomes.
PG  - 683-691
LID - 10.1007/s11060-023-04464-7 [doi]
AB  - PURPOSE: Intraoperative radiotherapy (IORT) has become a viable treatment option 
      for resectable brain metastases (BMs). As data on local control and radiation 
      necrosis rates are maturing, we focus on meaningful secondary endpoints such as 
      time to next treatment (TTNT), duration of postoperative corticosteroid 
      treatment, and in-hospital time. METHODS: Patients prospectively recruited within 
      an IORT study registry between November 2020 and June 2023 were compared with 
      consecutive patients receiving adjuvant stereotactic radiotherapy (SRT) of the 
      resection cavity within the same time frame. TTNT was defined as the number of 
      days between BM resection and start of the next extracranial oncological therapy 
      (systemic treatment, surgery, or radiotherapy) for each of the groups. RESULTS: 
      Of 95 BM patients screened, IORT was feasible in 84 cases (88%) and ultimately 
      performed in 64 (67%). The control collective consisted of 53 SRT patients. There 
      were no relevant differences in clinical baseline features. Mean TTNT (range) was 
      36 (9 - 94) days for IORT patients versus 52 (11 - 126) days for SRT patients 
      (p = 0.01). Mean duration of postoperative corticosteroid treatment was similar 
      (8 days; p = 0.83), as was mean postoperative in-hospital time (11 versus 12 
      days; p = 0.97). Mean total in-hospital time for BM treatment (in- and 
      out-patient days) was 11 days for IORT versus 19 days for SRT patients 
      (p < 0.001). CONCLUSION: IORT for BMs results in faster completion of 
      interdisciplinary treatment when compared to adjuvant SRT, without increasing 
      corticosteroid intake or prolonging in-hospital times. A randomised phase III 
      trial will determine the clinical effects of shorter TTNT.
CI  - (c) 2023. The Author(s).
FAU - Dejonckheere, Cas S
AU  - Dejonckheere CS
AD  - Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 
      53127, Bonn, Germany. cas.dejonckheere@ukbonn.de.
FAU - Layer, Julian P
AU  - Layer JP
AD  - Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 
      53127, Bonn, Germany.
AD  - Institute of Experimental Oncology, University Hospital Bonn, 53127, Bonn, 
      Germany.
FAU - Hamed, Motaz
AU  - Hamed M
AD  - Department of Neurosurgery, University Hospital Bonn, 53127, Bonn, Germany.
FAU - Layer, Katharina
AU  - Layer K
AD  - Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 
      53127, Bonn, Germany.
FAU - Glasmacher, Andrea
AU  - Glasmacher A
AD  - Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 
      53127, Bonn, Germany.
FAU - Friker, Lea L
AU  - Friker LL
AD  - Institute of Experimental Oncology, University Hospital Bonn, 53127, Bonn, 
      Germany.
AD  - Institute of Neuropathology, University Hospital Bonn, 53127, Bonn, Germany.
FAU - Potthoff, Anna-Laura
AU  - Potthoff AL
AD  - Department of Neurosurgery, University Hospital Bonn, 53127, Bonn, Germany.
FAU - Zeyen, Thomas
AU  - Zeyen T
AD  - Division of Clinical Neuro-Oncology, Department of Neurology, University Hospital 
      Bonn, 53127, Bonn, Germany.
FAU - Scafa, Davide
AU  - Scafa D
AD  - Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 
      53127, Bonn, Germany.
FAU - Koch, David
AU  - Koch D
AD  - Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 
      53127, Bonn, Germany.
FAU - Garbe, Stephan
AU  - Garbe S
AD  - Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 
      53127, Bonn, Germany.
FAU - Holz, Jasmin A
AU  - Holz JA
AD  - Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 
      53127, Bonn, Germany.
FAU - Kugel, Fabian
AU  - Kugel F
AD  - Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 
      53127, Bonn, Germany.
FAU - Grimmer, Molina
AU  - Grimmer M
AD  - Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 
      53127, Bonn, Germany.
FAU - Schmeel, Frederic Carsten
AU  - Schmeel FC
AD  - Department of Neuroradiology, University Hospital Bonn, 53127, Bonn, Germany.
FAU - Gielen, Gerrit H
AU  - Gielen GH
AD  - Institute of Neuropathology, University Hospital Bonn, 53127, Bonn, Germany.
FAU - Forstbauer, Helmut
AU  - Forstbauer H
AD  - Oncology Practice Network Troisdorf, 53840, Troisdorf, Germany.
FAU - Vatter, Hartmut
AU  - Vatter H
AD  - Department of Neurosurgery, University Hospital Bonn, 53127, Bonn, Germany.
FAU - Herrlinger, Ulrich
AU  - Herrlinger U
AD  - Division of Clinical Neuro-Oncology, Department of Neurology, University Hospital 
      Bonn, 53127, Bonn, Germany.
FAU - Giordano, Frank A
AU  - Giordano FA
AD  - Department of Radiation Oncology, University Medical Center Mannheim, 68167, 
      Mannheim, Germany.
FAU - Schneider, Matthias
AU  - Schneider M
AD  - Department of Neurosurgery, University Hospital Bonn, 53127, Bonn, Germany.
FAU - Schmeel, Leonard Christopher
AU  - Schmeel LC
AD  - Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 
      53127, Bonn, Germany.
FAU - Sarria, Gustavo R
AU  - Sarria GR
AD  - Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 
      53127, Bonn, Germany.
LA  - eng
PT  - Journal Article
DEP - 20231009
PL  - United States
TA  - J Neurooncol
JT  - Journal of neuro-oncology
JID - 8309335
RN  - 0 (Adrenal Cortex Hormones)
SB  - IM
MH  - Humans
MH  - Adrenal Cortex Hormones/therapeutic use
MH  - *Brain Neoplasms/radiotherapy/surgery
MH  - *Radiosurgery/methods
MH  - Radiotherapy, Adjuvant
MH  - Treatment Outcome
MH  - Prospective Studies
PMC - PMC10589145
OTO - NOTNLM
OT  - Brain metastasis
OT  - Intraoperative radiotherapy
OT  - Stereotactic radiotherapy
OT  - Time to next treatment
COIS- The authors declare no competing interests.
EDAT- 2023/10/09 12:42
MHDA- 2023/11/01 12:44
PMCR- 2023/10/09
CRDT- 2023/10/09 11:09
PHST- 2023/08/04 00:00 [received]
PHST- 2023/09/23 00:00 [accepted]
PHST- 2023/11/01 12:44 [medline]
PHST- 2023/10/09 12:42 [pubmed]
PHST- 2023/10/09 11:09 [entrez]
PHST- 2023/10/09 00:00 [pmc-release]
AID - 10.1007/s11060-023-04464-7 [pii]
AID - 4464 [pii]
AID - 10.1007/s11060-023-04464-7 [doi]
PST - ppublish
SO  - J Neurooncol. 2023 Sep;164(3):683-691. doi: 10.1007/s11060-023-04464-7. Epub 2023 
      Oct 9.