caa a22 4500 606216839 CHVBK 20210128101105.0 cr unu---uuuuu 210128e20151101xx s 000 0 eng 10.1007/s00701-015-2585-3 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2585-3 Experiences on two different stereotactic radiosurgery modalities of Gamma Knife and Cyberknife in treating brain metastases [Elektronische Daten] [Young Cho, Jung Lee, Doheui Lee, Jae Park, KyoungJun Yoon, Seon Kim, Do Kwon, Jeong Kim, Chang Kim, Sung Roh] Background: In this study, we compared the dosimetric properties between Gamma Knife (GK) and Cyberknife (CK), and investigated the clinical implications in treating brain metastases (BMs). Methods: Between 2011 and 2013, 77 patients treated with either single-fraction GK for small BMs (n = 40) or fractionated CK for large BMs >3cm (n = 37) were analyzed. Among a total of 160 lesions, 81 were treated with GK (median, 22Gy) and 38 (large lesions) with three- or five-fraction CK (median, 35Gy). The median tumor volume was 1.0cc (IQR, 0.12-4.4cc) for GK and 17.6cc (IQR, 12.8-23.7cc) for fractionated CK. A lesion-to-lesion dosimetric comparison was performed using the identical contour set in both systems. Results: The mean dose to tumor was significantly higher in GK by 1.25-fold (P < 0.001), whereas normal tissue volume receiving 90-10% of prescription dose was significantly larger in CK by 1.26-fold (P < 0.001). Nevertheless, no differences were observed in local tumor control (rates at 1year, 89.7% vs 87.0%; P = 0.594) and overall survival (median, 14 vs 16months; P = 0.493) between GK and fractionated CK groups. The incidences of radiation necrosis were also not different (12.3% vs 15.8%; P = 0.443). Conclusions: Despite slightly inferior dosimetric properties of CK, fractionated CK for large BMs appears to be as effective and safe as single-fraction GK for small BMs, representing fractionation as an effective strategy for enhancing efficacy and moderating toxicity in stereotactic radiosurgery for BMs. Springer-Verlag Wien, 2015 Stereotactic radiosurgery nationallicence Brain metastases nationallicence Fractionation nationallicence Gamma Knife nationallicence Cyberknife nationallicence Cho Young Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro-43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut Lee Jung Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro-43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut Lee Doheui Radiosurgery Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea aut Park Jae Radiosurgery Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea aut Yoon KyoungJun Radiosurgery Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea aut Kim Seon Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea aut Kwon Do Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro-43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut Kim Jeong Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro-43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut Kim Chang Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro-43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut Roh Sung Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro-43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut Acta Neurochirurgica Springer Vienna 157/11(2015-11-01), 2003-2009 0001-6268 157:11<2003 2015 157 701 https://doi.org/10.1007/s00701-015-2585-3 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2585-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Cho Young Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro-43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Lee Jung Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro-43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Lee Doheui Radiosurgery Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Park Jae Radiosurgery Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Yoon KyoungJun Radiosurgery Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Kim Seon Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Kwon Do Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro-43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Kim Jeong Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro-43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Kim Chang Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro-43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Roh Sung Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro-43-gil, 138-736, Songpa-gu, Seoul, Republic of Korea aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/11(2015-11-01), 2003-2009 0001-6268 157:11<2003 2015 157 701