Radiation Treatment with Modulated Volumetric Arc Technique in Multiple Brain Metastases. Review of literature and clinical cases.

Abstract

OBJECTIVE: to present the results of our experience with stereotactic radiosurgery (SRS) with the Volumetric Modulated Arc Technique (VMAT) in multiple brain metastases (MBM). METHOD: a retrospective review of 17 patients with multiple brain metastases was carried out during the period 2011-2022, the technique used was the Modulated Volumetric Arc Technique with a single isocenter. RESULTS: A total of 17 patients with multiple brain metastases who met the inclusion criteria established for this study, treated with SRS with VMAT with and without prior Holocranial Radiotherapy, were analyzed. The average age was 62.2 years, 59% of the patients studied presented a Karnofsky score greater than 90, the range of predominant lesions was from 3 to 6 metastatic lesions, representing 76% of the sample. Extracranial disease was present in slightly more than 50% of the patients, the most frequent primary tumor was lung 76.4%, the predominant location was supratentorial and infratentorial with 52.9% of the sample. Only 1 patient had a lesion >4mm, none of the patients involved received surgical treatment or underwent biopsy of metastatic lesions; It should be noted that of the patients involved in the study, only 1 had a second course of SRS. CONCLUSION: SRS with VMAT is an important modality in the management of patients with MBM that shortens treatment times and allows the protection of adjacent brain tissue with disease control.