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Table 3 Radiotherapy dose and fractionation

From: A phase III, multicenter, randomized controlled trial of preoperative versus postoperative stereotactic radiosurgery for patients with surgically resectable brain metastases

Tumor Bed (standard arm)

(prescription is based on CTV volume)

Intact metastases (both arms)

(prescription is based on the CTV maximal diameter)

Lesions < 4.2 cc receive 20 Gy

Lesions < 1.0 cm receive 22–24 Gy

Lesions ≥4.2 to < 14.4 cc receive 17 Gy

Lesions ≥1.0 to < 2.0 cm receive 20–22 Gy

Lesions ≥14.4 to < 30 cc receive 27 Gy in three or 30 Gy in 5 fractions

Lesions ≥2.0 to < 3.0 cm receive 18–20 Gy

Lesions ≥30 cc receive 24–27 Gy in 3 fractions or 30 Gy in five fractions

Lesions ≥3.0 to < 5.0 cm receive 27 Gy in 3 or 30 Gy in five fractions

 

Lesions ≥5.0 cm receive 24–27 Gy in three fractions or 30 Gy in five fractions

  1. The dose should be prescribed to the highest isodose line encompassing the CTV and be between the 50 and 90% of the maximum dose
  2. Abbreviation: CTV clinical target volume