Comparing intraoperative radiotherapy (IORT) and hypofractionated stereotactic radiotherapy (HSRT) after brain metastasis surgery: impact on oncological outcome and radionecrosis - Summary - MDSpire
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Comparing intraoperative radiotherapy (IORT) and hypofractionated stereotactic radiotherapy (HSRT) after brain metastasis surgery: impact on oncological outcome and radionecrosis
To compare the oncological outcomes and treatment-related toxicity of IORT and HSRT in patients undergoing resection of brain metastases, focusing on primary endpoints such as survival rates and incidence of radionecrosis.
Key Findings:
The overall one-year incidence of radionecrosis (RN) was significantly lower in the IORT group (3.7%) compared to the HSRT group (21.8%), indicating a potential advantage of IORT in minimizing treatment-related toxicity.
Median operation room time was increased by 25 minutes in the IORT group, which may impact surgical workflow.
No significant differences in baseline characteristics, RPA classification, or metastasis size between groups, suggesting comparable patient populations.
Interpretation:
IORT may provide a lower risk of radionecrosis compared to HSRT while allowing for immediate radiation delivery during surgery, which could enhance patient outcomes and streamline treatment protocols.
Limitations:
Retrospective design may introduce selection bias, and the limited sample size may affect the generalizability of results, necessitating further studies to confirm findings.
Conclusion:
IORT shows promise as a viable alternative to HSRT for adjuvant therapy after brain metastasis surgery, particularly in reducing the incidence of radionecrosis, but further research is needed to validate these findings.
by Maria Neu, Ehab Shiban, Philipp Krauss, Björn Sommer, Zoha Roushan, Susanne Gutser, Christoph J. Maurer, Tilman Janzen, Georg Stüben, Klaus-Henning Kahl
