[Repeated irradiation of brain metastases under stereotactic conditions: A review of the literature]

Abstract

Stereotactic radiotherapy has become a standard in the management of patients with brain metastases; its main interest is to differ whole brain radiotherapy, provider of neurocognitive toxicity and to increase the rate of local control. The repetition of radiotherapy sessions under stereotactic conditions is not codified, neither on the number of technically and clinically possible sessions, nor on the maximum total number or volume of metastases to be treated. The purpose of this review is to analyse the data in the literature concerning repeated irradiations under stereotactic conditions. The second reirradiation in stereotactic condition shows satisfactory results in terms of overall survival, local control, and toxicity. However, we lack data for patients receiving more than two sessions of SRS as well as to define dose constraints to reirradiated healthy tissues. Prospective trials are still needed to validate the management of recurrent brain metastases after initial SRS.

Keywords: Brain metastases; Métastases cérébrales; Radiotherapy; Radiothérapie; Radiothérapie en conditions stéréotaxiques; Reirradiation; Repeated radiosurgery; Réirradiation; Stereotactic radiosurgery; Stéréotaxie répétée.