‘Sandwich treatment’ for posterior fossa brain metastases with volume larger than 4cm3: a multicentric retrospective study

AbstractSingle stereotactic radiosurgery (SRS) for posterior fossa brain metastases (BM) larger than 4cm3 is dangerous. ‘Sandwich treatment’ strategy was developed for these BMs. The strategy was one week treatment course which includes 2-stage SRS and using Bevacizumab once during SRS gap. Patients from four gamma knife center were retrospectively analyzed. The changes of tumor and peri-tumor edema volume were s tudied. The Dizziness Handicap Inventory (DHI) Vomiting Score (VS) and Glasgow Coma Scale (GCS) were used to evaluate patients’ clinical symptom changes. Karnofsky performance scale (KPS) and Barthel Index (BI) were used to evaluate patients’ overall fitness status and physical activity rehabili tation. Tumor local control (TLC) and patients’ overall survival (OS) rate were also calculated. Forty patients with 45 LBMs received ‘Sandwich treatment’. The mean edema volume reduced remarkably at the course of therapy and 3 months later (P <  0.01). The mean tumor volume greatly decreased 3 months later (P <  0.01). Patients’ clinical symptoms that reflected by median score of DHI, VS, GCS were improved dramatically at the course of therapy and 3 months later (P <  0.01). Similar changes happened in median score of KPS and BI that reflected patients’ overall fitness status and physical activity rehabilitation (P <  0.01). Patients’ median OS was 14.3 months, with 95.4%, 76.2%, and 26.3% survival rate at 6, 12, 24 months. The...

Source: Clinical and Experimental Metastasis - July 13, 2023 Category: Cancer & Oncology Source Type: research