Results of three-dimensional stereotactically-guided radiotherapy in recurrent XXXX .

@entity1 @entity137 @entity5 @entity6831 @entity2946
PURPOSE: To evaluate survival rates and side effects after stereotactically-guided radiotherapy (SRT) in @entity1 with recurrent @entity2946 of the brain. METHODS AND MATERIALS: Between 1992 and 2000, 20 @entity1 with 29 radiological manifestations were treated with fractionated SRT (n = 21) or radiosurgery (n = 8). Median age was 16 years with 6 @entity1 < or = 14 years. All @entity1 had prior cranio-spinal radiotherapy plus boost to the posterior fossa with a total dose of 54 Gy. Time to recurrence was 33 months mean. Eighteen of the 29 lesions were located within the boost volume. Chemotherapy was given according to current international study protocols (HIT) in all @entity1 . Mean total dose for re-irradiation was 24 Gy for fractionated stereotactically-guided radiotherapy, and 15 Gy for radiosurgery. Mean follow-up was 88.5 months. RESULTS: Overall local control was 89.7%. Thirteen recurrences showed partial or complete response in CT/MR-imaging, 13 showed stable disease. Local @entity5 progression was seen 5 months mean after radiotherapy in three cases. A multifocal intracranial progression was seen in 9 @entity1 , 5 @entity1 developed additional spinal metastases. Thirteen @entity1 died with disseminated cranio-spinal progression, after 72.6 months median. No late @entity137 > CTC II(o) especially no brain radionecrosis was seen after radiotherapy. CONCLUSION: SRT is effective and safe in the treatment of recurrent @entity2946 to improve local control without evident side effects. The main problem remains the control of subclinical @entity6831 .
