BACKGROUND: Achieving durable local control while limiting normal tissue @entity137 with definitive radiation therapy in the management of high-risk brain @entity3 remains a radiobiological challenge. The objective of this study was to examine the local control and @entity137 of a 5-fraction stereotactic radiosurgical approach for treatment of @entity1 with inoperable single high-risk @entity1149 brain @entity3 . METHODS: This retrospective analysis examines 20 @entity1 who were deemed to have "high-risk" brain @entity3 . High-risk @entity5 were defined as those with a maximum diameter greater than 2  cm and/or those located within an eloquent cortex. @entity1 were evaluated by a neurosurgeon prior to treatment and determined to be inoperable due to @entity5 or @entity1 characteristics. @entity1 were treated using the CyberKnife   SRS system in 5 fractions to a total dose of 30  Gy, 35  Gy, or 40  Gy. RESULTS: Twenty @entity1 with a median age of 65.5  years were treated from April 2010 to August 2014 in 5 fractions to a median total dose of 35  Gy. At a median follow up of 11.3  months @entity5 control was observed in 18 of 20 @entity3 (90  %). Both local failures were observed in @entity1 receiving a lower dose of 30  Gy. Median pre-treatment @entity619 dose was 10  mg/day and median post-treatment nadir dose was 0  mg/day. Salvage intracranial therapy was required in 45  % of @entity1 . Symptomatic radionecrosis was observed in 4 of 20 @entity1 (20  %), two of which were treated to 40  Gy and the remainder to 35  Gy. Kaplan-Meier 1-year, 2-year, and median survival were calculated to be 45  %, 20  %, and 13.2  months, respectively. CONCLUSIONS: Five-fraction SRS to a total dose of 35  Gy appears to be a safe and effective management strategy for single high-risk @entity1149 brain @entity3 , while a total dose of 40  Gy leads to an excess risk of @entity2359 .

Five-fraction stereotactic radiosurgery (SRS) for single inoperable high-risk @entity1149 ( XXXX ) brain @entity3 .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'local tumor', 'tumors'] @entity1149 :: ('MESH:D002289', 'Disease') :: ['NSCLC'] @entity619 :: ('MESH:D003907', 'Chemical') :: ['dexamethasone'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases'] @entity2359 :: ('MESH:D020258', 'Disease') :: ['neurotoxicity']
@entity1149 :: (MESH:D002289,Disease) :: ['NSCLC']
