A phase II clinical trial of frameless, fractionated stereotactic radiation therapy for brain metastases

Amit K. Garg; Mike Hernandez; Pamela J. Schlembach; John R. Bowers; Mary F. McAleer; Paul D. Brown; Ramesh Gopal; Lee Wiederhold; Todd Swanson; Shalin J. Shah; Jing Li; Sherise D. Ferguson; Nancy V. Philip; Lilybeth Degracia; Elizabeth S. Bloom; Stephen G. Chun

doi:10.1093/jncics/pkad093

A phase II clinical trial of frameless, fractionated stereotactic radiation therapy for brain metastases

Amit K. Garg, Mike Hernandez, Pamela J. Schlembach, John R. Bowers, Mary F. McAleer, Paul D. Brown, Ramesh Gopal, Lee Wiederhold, Todd Swanson, Shalin J. Shah, Jing Li, Sherise D. Ferguson, Nancy V. Philip, Lilybeth Degracia, Elizabeth S. Bloom, Stephen G. Chun

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Abstract

Stereotactic radiation therapy yields high rates of local control for brain metastases, but patients in rural or suburban areas face geographic and socioeconomic barriers to its access. We conducted a phase II clinical trial of frameless, fractionated stereotactic radiation therapy for brain metastases in an integrated academic satellite network for patients 18 years of age or older with 4 or fewer brain metastases. Dose was based on gross tumor volume: less than 3.0 cm, 27 Gy in 3 fractions and 3.0 to 3.9 cm, 30 Gy in 5 fractions. Median follow-up was 10 months for 73 evaluable patients, with a median age of 68 years. Median intracranial progression-free survival was 7.1 months (95% confidence interval = 5.3 to not reached), and median survival was 7.2 months (95% confidence interval = 5.4 to not reached); there were no serious adverse events. Outcomes of this trial compare favorably with contemporary trials, and this treatment strategy provides opportunities to expand stereotactic radiation therapy access to underserved populations.

Original language	English (US)
Article number	pkad093
Journal	JNCI Cancer Spectrum
Volume	7
Issue number	6
DOIs	https://doi.org/10.1093/jncics/pkad093
State	Published - Dec 1 2023
Externally published	Yes

ASJC Scopus subject areas

Oncology
Cancer Research

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Garg, A. K., Hernandez, M., Schlembach, P. J., Bowers, J. R., McAleer, M. F., Brown, P. D., Gopal, R., Wiederhold, L., Swanson, T., Shah, S. J., Li, J., Ferguson, S. D., Philip, N. V., Degracia, L., Bloom, E. S., & Chun, S. G. (2023). A phase II clinical trial of frameless, fractionated stereotactic radiation therapy for brain metastases. JNCI Cancer Spectrum, 7(6), Article pkad093. https://doi.org/10.1093/jncics/pkad093

Garg, AK, Hernandez, M, Schlembach, PJ, Bowers, JR, McAleer, MF, Brown, PD, Gopal, R, Wiederhold, L, Swanson, T, Shah, SJ, Li, J, Ferguson, SD, Philip, NV, Degracia, L, Bloom, ES & Chun, SG 2023, 'A phase II clinical trial of frameless, fractionated stereotactic radiation therapy for brain metastases', JNCI Cancer Spectrum, vol. 7, no. 6, pkad093. https://doi.org/10.1093/jncics/pkad093

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title = "A phase II clinical trial of frameless, fractionated stereotactic radiation therapy for brain metastases",

abstract = "Stereotactic radiation therapy yields high rates of local control for brain metastases, but patients in rural or suburban areas face geographic and socioeconomic barriers to its access. We conducted a phase II clinical trial of frameless, fractionated stereotactic radiation therapy for brain metastases in an integrated academic satellite network for patients 18 years of age or older with 4 or fewer brain metastases. Dose was based on gross tumor volume: less than 3.0 cm, 27 Gy in 3 fractions and 3.0 to 3.9 cm, 30 Gy in 5 fractions. Median follow-up was 10 months for 73 evaluable patients, with a median age of 68 years. Median intracranial progression-free survival was 7.1 months (95% confidence interval = 5.3 to not reached), and median survival was 7.2 months (95% confidence interval = 5.4 to not reached); there were no serious adverse events. Outcomes of this trial compare favorably with contemporary trials, and this treatment strategy provides opportunities to expand stereotactic radiation therapy access to underserved populations.",

author = "Garg, {Amit K.} and Mike Hernandez and Schlembach, {Pamela J.} and Bowers, {John R.} and McAleer, {Mary F.} and Brown, {Paul D.} and Ramesh Gopal and Lee Wiederhold and Todd Swanson and Shah, {Shalin J.} and Jing Li and Ferguson, {Sherise D.} and Philip, {Nancy V.} and Lilybeth Degracia and Bloom, {Elizabeth S.} and Chun, {Stephen G.}",

note = "Publisher Copyright: {\textcopyright} 2023 The Author(s). Published by Oxford University Press.",

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doi = "10.1093/jncics/pkad093",

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AU - Brown, Paul D.

AU - Gopal, Ramesh

AU - Wiederhold, Lee

AU - Swanson, Todd

AU - Shah, Shalin J.

AU - Li, Jing

AU - Ferguson, Sherise D.

AU - Philip, Nancy V.

AU - Degracia, Lilybeth

AU - Bloom, Elizabeth S.

AU - Chun, Stephen G.

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N2 - Stereotactic radiation therapy yields high rates of local control for brain metastases, but patients in rural or suburban areas face geographic and socioeconomic barriers to its access. We conducted a phase II clinical trial of frameless, fractionated stereotactic radiation therapy for brain metastases in an integrated academic satellite network for patients 18 years of age or older with 4 or fewer brain metastases. Dose was based on gross tumor volume: less than 3.0 cm, 27 Gy in 3 fractions and 3.0 to 3.9 cm, 30 Gy in 5 fractions. Median follow-up was 10 months for 73 evaluable patients, with a median age of 68 years. Median intracranial progression-free survival was 7.1 months (95% confidence interval = 5.3 to not reached), and median survival was 7.2 months (95% confidence interval = 5.4 to not reached); there were no serious adverse events. Outcomes of this trial compare favorably with contemporary trials, and this treatment strategy provides opportunities to expand stereotactic radiation therapy access to underserved populations.

AB - Stereotactic radiation therapy yields high rates of local control for brain metastases, but patients in rural or suburban areas face geographic and socioeconomic barriers to its access. We conducted a phase II clinical trial of frameless, fractionated stereotactic radiation therapy for brain metastases in an integrated academic satellite network for patients 18 years of age or older with 4 or fewer brain metastases. Dose was based on gross tumor volume: less than 3.0 cm, 27 Gy in 3 fractions and 3.0 to 3.9 cm, 30 Gy in 5 fractions. Median follow-up was 10 months for 73 evaluable patients, with a median age of 68 years. Median intracranial progression-free survival was 7.1 months (95% confidence interval = 5.3 to not reached), and median survival was 7.2 months (95% confidence interval = 5.4 to not reached); there were no serious adverse events. Outcomes of this trial compare favorably with contemporary trials, and this treatment strategy provides opportunities to expand stereotactic radiation therapy access to underserved populations.

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A phase II clinical trial of frameless, fractionated stereotactic radiation therapy for brain metastases

Abstract

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