Treatment Outcomes After Higher-dose Fractionated Stereotactic Radiotherapy (FSRT) Alone for 1-4 Brain Metastases

Leonie Johannwerner, Elisa M. Werner, Stefan Janssen, Nathan Y. Yu, Dirk Rades


BACKGROUND/AIM: Fractionated stereotactic radiotherapy (FSRT) is increasingly used for brain metastases. We investigated higher-dose FSRT with biologically effective doses (BED) of 49.6-66.7 Gy12 Patients and Methods: Eleven characteristics were evaluated for local control (LC), overall survival (OS), and freedom from radiation necrosis (RN) in 69 patients with 1-4 brain metastases. Fifty-seven patients (83%) had extracranial metastases, 23 (33%) Karnofsky performance scores (KPS) ≤70, and 21 (30%) brain metastases ≥21 mm. RESULTS: At 1 and 2 years, LC-rates were 81% and 63%, OS-rates 66% and 43%, and freedom from RN-rates 98% and 87%, respectively. Median time to local progression was 35 months, median survival 19 months. KPS ≥90 was associated with better OS (p=0.048). BED of 49.6-57 Gy12 (vs. 63-66.7 Gy12) was associated with higher rates of freedom from RN (p=0.046), not with LC (p=0.78) or OS (p=0.55). CONCLUSION: Higher-dose FSRT appears feasible and effective in patients with 1-4 brain metastases. BED 63-66.7 Gy12 may not improve LC and OS but may increase RN risk.

Original languageEnglish
JournalAnticancer Research
Issue number6
Pages (from-to)2757-2762
Number of pages6
Publication statusPublished - 01.06.2023

Research Areas and Centers

  • Research Area: Luebeck Integrated Oncology Network (LION)
  • Centers: University Cancer Center Schleswig-Holstein (UCCSH)

DFG Research Classification Scheme

  • 205-30 Radiology, Nuclear Medicine, Radiation Therapy and Radiobiology
  • 205-14 Haematology, Oncology


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