Health care of Kyrgyzstan
Zdravoohraneniye Kyrgyzstana

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Advantages of stereotactic radiotherapy in the treatment of brain oligometastases: results of a prospective study

Advantages of stereotactic radiotherapy in the treatment of brain oligometastases: results of a prospective study
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Abstract

Relevance. Globally, breast cancer (BC) and lung cancer (LC) have remained the leading cancers in incidence for many years, ranking first and second, respectively. In terms of mortality, LC consistently holds first place, while BC ranks fifth. A similar situation is observed in the Republic of Kazakhstan: in 2021, BC ranked first in incidence, while LC ranked second. In terms of mortality, LC ranks first in the country, while BC ranks third. In 1995, S. Hellman and R. Weichselbaum formulated the concept of the "oligometastatic state" – an intermediate stage between localized tumor progression and generalized metastatic disease. It has been shown that in some cases, removal of a limited number of metastases can increase patient survival and reduce tumor burden. Stereotactic radiosurgery (SRS) enables targeted treatment of lesion foci, minimizing damage to healthy tissue and delaying the need for systemic chemotherapy. Study Objective: To evaluate the potential for improving the treatment efficacy of brain oligometastases in patients with lung cancer and breast cancer using modern stereotactic radiotherapy technologies. Materials and Methods: This prospective study included 100 patients with verified brain oligometastases from lung and breast cancer. Patients were divided into two equal groups: - Group 1 (n=50): total brain irradiation (WBRT) with a total focal dose of 30 Gy in 10 fractions; - Group 2 (n=50): stereotactic radiotherapy (SRT) with a single dose of 21 Gy to the metastatic foci. Efficacy was assessed using follow-up MRI scans at 3, 6, 9, and 12 months, as well as overall survival (OS) and disease-free survival (PFS) at 24 months of follow-up. Statistical data were processed using the χ² test; differences were considered significant at p<0.05. Results and Discussion. The SRT group demonstrated a higher complete tumor response rate compared to the WBRT group: 80% versus 46% (p=0.002). Partial responses were observed in 18% of patients in the SRT group and 40% of patients in the WBRT group, with disease progression occurring in 2% versus 14% of patients, respectively. The median disease-free survival was 18.4 months in the SRT group versus 10.7 months in the WBRT group (p<0.001). The overall two-year survival rate reached 72% in the SRT group and 48% in the WBRT group (p=0.01). During the follow-up period, no clinically significant radiation-induced complications were observed in the SRT group. The treatment was well tolerated, and no additional medical support was required. Conclusion: Stereotactic radiotherapy provides a higher local control rate and significantly increases relapse-free and overall survival in patients with oligometastases in the brain compared to total body irradiation, while demonstrating a low toxicity profile.

About the authors

Куатжанова Камшат Куатжановна – радиационный онколог Центра радиационной онкологии АО «Казахский научно-исследовательский институт онкологии и радиологии».
Эл. адрес: This email address is being protected from spambots. You need JavaScript enabled to view it.
Контактный телефон: 8 747 546 9594
ID ORCHID: https://orcid.org/0009-0002-6416-4824
Мыңжасарова Шапағат Жалғасқызы – радиационный онколог Центра радиационной онкологии АО «Казахский научно-исследовательский институт онкологии и радиологии».
Эл. адрес: This email address is being protected from spambots. You need JavaScript enabled to view it.
Контактный телефон: 8 778 269 51 20
ID ORCHID: https://orcid.org/0009-0003-5568-3152

Мыңжасарова Шапағат Жалғасқызы – радиационный онколог Центра радиационной онкологии АО «Казахский научно-исследовательский институт онкологии и радиологии».
Эл. адрес: This email address is being protected from spambots. You need JavaScript enabled to view it.
Контактный телефон: 8 778 269 51 20
ID ORCHID: https://orcid.org/0009-0003-5568-3152
Жасаралова Айнұр Асанқызы – радиационный онколог Центра радиационной онкологии АО «Казахский научно-исследовательский институт онкологии и радиологии».
Эл. адрес: This email address is being protected from spambots. You need JavaScript enabled to view it.
Контактный телефон: 8 775 166 87 91
ID ORCHID: https://orcid.org/0009-0007-6561-6948
Ким Виктор Борисович – руководитель Центра радиационной онкологии АО «Казахский научно-исследовательский институт онкологии и радиологии», доктор медицинских наук
Эл. адрес: This email address is being protected from spambots. You need JavaScript enabled to view it.
Контактный телефон: 8 701 744 62 80
ORCID ID: https://orcid.org/0000-0001-7923-3568

Kuatzhanova Kamshat Kuatzhanovna – radiation oncologist of the Center for Radiation Oncology of JSC “Kazakh Research Institute of Oncology and Radiology”.
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Contact phone: 8 747 546 9594
ORCHID ID: https://orcid.org/0009-0002-6416-4824
Myngzhasarova Shapagat Zhalgaskyzy – radiation oncologist of the Center for Radiation Oncology of JSC “Kazakh Research Institute of Oncology and Radiology”.
E-mail: address: This email address is being protected from spambots. You need JavaScript enabled to view it.
Contact phone: 8 778 269 51 20
ORCHID ID: https://orcid.org/0009-0003-5568-3152

Mynzhasarova Shapagat Zhalgaskyzy – radiation oncologist of the Radiation Oncology Center of JSC “Kazakh Research Institute of Oncology and Radiology”.
E-mail: address: This email address is being protected from spambots. You need JavaScript enabled to view it.
Contact phone: 8 778 269 51 20
ORCHID ID: https://orcid.org/0009-0003-5568-3152
Zhasaralova Ainur Asankyzy – radiation oncologist of the Radiation Oncology Center of JSC “Kazakh Research Institute of Oncology and Radiology”.
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Contact phone: 8 775 166 87 91
ORCHID ID: https://orcid.org/0009-0007-6561-6948
Kim Viktor Borisovich – head of the Radiation Oncology Center of JSC “Kazakh Research Institute of Oncology and Radiology”, Doctor of Medical Sciences
E-mail: address: This email address is being protected from spambots. You need JavaScript enabled to view it.
Contact phone: 8 701 744 62 80
ORCID ID: https://orcid.org/0000-0001-7923-3568

References

Authors Kuatzhanovna K.K., Mynzhasarova Zh.P., Zhasaralova A.A.
Pages 123-124
Russian
Об авторах

Куатжанова Камшат Куатжановна – радиационный онколог Центра радиационной онкологии АО «Казахский научно-исследовательский институт онкологии и радиологии».
Эл. адрес: This email address is being protected from spambots. You need JavaScript enabled to view it.
Контактный телефон: 8 747 546 9594
ID ORCHID: https://orcid.org/0009-0002-6416-4824
Мыңжасарова Шапағат Жалғасқызы – радиационный онколог Центра радиационной онкологии АО «Казахский научно-исследовательский институт онкологии и радиологии».
Эл. адрес: This email address is being protected from spambots. You need JavaScript enabled to view it.
Контактный телефон: 8 778 269 51 20
ID ORCHID: https://orcid.org/0009-0003-5568-3152

Мыңжасарова Шапағат Жалғасқызы – радиационный онколог Центра радиационной онкологии АО «Казахский научно-исследовательский институт онкологии и радиологии».
Эл. адрес: This email address is being protected from spambots. You need JavaScript enabled to view it.
Контактный телефон: 8 778 269 51 20
ID ORCHID: https://orcid.org/0009-0003-5568-3152
Жасаралова Айнұр Асанқызы – радиационный онколог Центра радиационной онкологии АО «Казахский научно-исследовательский институт онкологии и радиологии».
Эл. адрес: This email address is being protected from spambots. You need JavaScript enabled to view it.
Контактный телефон: 8 775 166 87 91
ID ORCHID: https://orcid.org/0009-0007-6561-6948
Ким Виктор Борисович – руководитель Центра радиационной онкологии АО «Казахский научно-исследовательский институт онкологии и радиологии», доктор медицинских наук
Эл. адрес: This email address is being protected from spambots. You need JavaScript enabled to view it.
Контактный телефон: 8 701 744 62 80
ORCID ID: https://orcid.org/0000-0001-7923-3568
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About authors

Kuatzhanova Kamshat Kuatzhanovna – radiation oncologist of the Center for Radiation Oncology of JSC “Kazakh Research Institute of Oncology and Radiology”.
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Contact phone: 8 747 546 9594
ORCHID ID: https://orcid.org/0009-0002-6416-4824
Myngzhasarova Shapagat Zhalgaskyzy – radiation oncologist of the Center for Radiation Oncology of JSC “Kazakh Research Institute of Oncology and Radiology”.
E-mail: address: This email address is being protected from spambots. You need JavaScript enabled to view it.
Contact phone: 8 778 269 51 20
ORCHID ID: https://orcid.org/0009-0003-5568-3152

Mynzhasarova Shapagat Zhalgaskyzy – radiation oncologist of the Radiation Oncology Center of JSC “Kazakh Research Institute of Oncology and Radiology”.
E-mail: address: This email address is being protected from spambots. You need JavaScript enabled to view it.
Contact phone: 8 778 269 51 20
ORCHID ID: https://orcid.org/0009-0003-5568-3152
Zhasaralova Ainur Asankyzy – radiation oncologist of the Radiation Oncology Center of JSC “Kazakh Research Institute of Oncology and Radiology”.
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Contact phone: 8 775 166 87 91
ORCHID ID: https://orcid.org/0009-0007-6561-6948
Kim Viktor Borisovich – head of the Radiation Oncology Center of JSC “Kazakh Research Institute of Oncology and Radiology”, Doctor of Medical Sciences
E-mail: address: This email address is being protected from spambots. You need JavaScript enabled to view it.
Contact phone: 8 701 744 62 80
ORCID ID: https://orcid.org/0000-0001-7923-3568
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