Table 1.
Comparative retrospective studies of single-fraction (grey lines) vs. multi-fraction (white lines), local control (LC), , , radionecrosis and toxicities.
| Authors | N. Patients | N. Metastases | Median Volume (PTV) | Doses/Prescription Isodoses | GTV-PTV Margin (mm) | Treatment Devices |
Histology | Previous WBRT (%) |
(Gy) | LC at 6 Months (%) | LC at 12 Months (%) | (Gy) | Radionecrosis (N)/Toxicities (%) (c) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Kim et al. (2011) | 58 | 81 | 2.21 cc (0.03–24.34) | 20 Gy (15–22)/90% | 1 | LINAC | Various | 21% | 60 | 81 | 71 | 153 | 1/17% |
| 40 | 49 | 5.00 cc (0.14–37.80) | 36 Gy in 6 fr. (30–42)/91% | 1 | 40% | 57.6 | 97 | 69 | 108 | 0/5% | |||
| Wiggenraad et al. (2012) | 41 | 46 | <13 cc = 11 13–20 c = 17 >20 cc = 18 |
15 Gy | 2 | LINAC | Various | 25% | 37.5 | 89 | 67 | 90 | NA |
| 51 | 65 | <13 cc = 18 13–22 c = 16 >20 cc = 31 |
24 Gy in 3 fr./80% | 2 | 15% | 43.2 | 92 | 75 | 88 | NA | |||
| Fokas et al. (2012) | 107 | NA | 1.87 cc (0.03–11.17) | RTOG 90-05 schedule/NA | 2 | LINAC | Various | No | 60 | 84 | 73 | 153 | 4/14% |
| 54 53 |
2.04 cc (1.17–18.71) 5.93 cc (2.7–23.16) |
35 Gy in 7 fr./NA 40 Gy in 10 fr./NA |
3 3 |
52.5 56 |
87 81 |
75 71 |
93.3 92 |
1/6% 0/2% |
|||||
| Feuvret et al. (2014) | 24 | 24 | 18.31 cc (6.31–39.21) | 14 Gy/70% | 1 | LINAC | Various | No | 33.6 | 68 | 58 | 79.3 | 0/28% |
| 12 | 12 | 32.61 cc (19.10–65.56) | 23.1 Gy in 3 fr./70% | 2 | 41 | 100 | 100 | 82.4 | 0/25% | ||||
| Ishihara et al. (2016) | 53 in total | 138 | 0.7 cc (0.1–8.3) | 20 Gy (15–25)/80–90% | 1 | LINAC | Lung | 7.6% In total |
60 | NA | NA (b) | 153.3 | 21/0% (≥grade II) |
| 76 | 6.2 cc (0.1–29.5) | 28 Gy (19.2–39) in 3–13 fr./80–90% | 1–2 | 43.7 (a) | NA | 83.6 | 80.3 (b) | 5/0% (≥grade II) | |||||
| Minniti et al. (2016) | 151 | 179 | 12.2 cc (4.4–32) | 18 Gy or 15–16 Gy/80–90% | 1–2 | LINAC | Various | No | 50.4 or 37.5–41.6 | 94 | 77 | 126 or 90–101.3 | 31/NA |
| 138 | 164 | 17.9 cc (5.6–54) | 27 Gy in 3 fr./80–90% | 1–2 | 51.3 | 97 | 90 | 108 | 11/NA | ||||
| Lesueur et al. (2018) | 60 in total | 52 | 0.47 cc | 20 Gy (18–25)/80% | 2 | CyberKnife | Melanoma and kidney | No | 60 | 89 | 79 | 153.3 | 5/NA |
| 141 | 1.75 cc | 30 Gy (30–33) in 3–6 fractions/80% | 2 | 60 | 80 | 72 | 90 | 10/NA | |||||
| Chon et al. (2019) | 67 | 154 | 9.7 cc (6.8–15.9) | 20 Gy (18–22)/50% | 0 | GammaKnife | Various | No | 60 | 92.9 | 66.6 | 153.3 | NA/56% |
| 38 | 73 | 11 cc (6–14.8) | 35 Gy (27–41) in 3 or 5 fractions/80% | 0 | CyberKnife | 59.5 (5 fractions) | 100 | 92.4 | 93.3 | NA/36% | |||
| Loo et al. (2020) | 152 in total | 105 | 0.76 cc (0.27–11.4) | 14 Gy/70% | 2 | LINAC | Various | No | 33.6 | 94 | 88 | 79.3 | 1/NA |
| 141 | 4.51 cc (0.29–43.4) | 23.1 Gy in 3 fr/70% | 2 | 41 | 88 | 78 | 82.4 | 9/NA | |||||
| Remick et al. (2020) | 156 in total | 222 | 0.7 cm (0.2–3.3) (GTV) | RTOG 90-05 schedule, median 24 Gy/50–80% | 0/NA |
LINAC
GammaKnife |
Various | 33% | Median 81.6 | NA | 91 | 216 | 20/NA |
| 113 | 1.6 cm (0.2–5) (GTV) |
Variable/2 to 5 fractions | NA | LINAC | 34% | 42.6 | NA | 85 | - | 8/NA | |||
| Putz et al. (2020) | 120 in total | 92 | 0.23 (0.12–0.50) |
18 Gy (18–20)/80% | 1–2 | LINAC | Various | 20.7% | 50.4 | >60% | 55.6 | 126 | 8/NA |
| 98 | 1.42 (0.07–61.98) |
40 Gy in 10 fr./80% | 1–2 | 15.3% | 56 | >80% | 70.2 | 93.3 | 2/NA |
NA = not available, (a) BED calculation with marginal median dose to 5 fractions, (b) only available to <4 cc volume sub-group, (c) grade I to V according to CTCAE.