Skip to main content
SpringerLink
Log in

Stereotactic Radiosurgery for Brain Metastases

  • Chapter
  • First Online:
Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy

  • 1388 Accesses

Abstract

The utilization of stereotactic radiosurgery in patients with brain metastases has grown significantly in the past few decades, predominately owing to its demonstrated improvements in local tumor control and reduction in neurocognitive deficits when compared to whole brain radiation therapy. This has been shown in the primary as well as postoperative setting. Future developments in systemic therapies and radiosurgical technique will continue to advance the efficacy and utilization of this technique.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Barnholtz-Sloan JS, Yu C, Sloan AE, Vengoechea J, Wang M, Dignam JJ, et al. A nomogram for individualized estimation of survival among patients with brain metastasis. Neuro-Oncology. 2012;14(7):910–8.

    Article  Google Scholar 

  2. Eichler AF, Loeffler JS. Multidisciplinary management of brain metastases. Oncologist. 2007;12(7):884–98.

    Article  CAS  Google Scholar 

  3. Patchell RA, Tibbs PA, Walsh JW, Dempsey RJ, Maruyama Y, Kryscio RJ, et al. A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med. 1990;322(8):494–500.

    Article  CAS  Google Scholar 

  4. Patchell RA, Tibbs PA, Regine WF, Dempsey RJ, Mohiuddin M, Kryscio RJ, et al. Postoperative radiotherapy in the treatment of single metastases to the brain: a randomized trial. JAMA. 1998;280(17):1485–9.

    Article  CAS  Google Scholar 

  5. Network NCC. NCCN clinical practice guidelines in Oncology: Central Nervous System Cancers Version 1.2017. 2017. Available from: https://www.nccn.org/professionals/physician_gls/pdf/cns.pdf.

  6. Mulvenna P, Nankivell M, Barton R, Faivre-Finn C, Wilson P, McColl E, et al. Dexamethasone and supportive care with or without whole brain radiotherapy in treating patients with non-small cell lung cancer with brain metastases unsuitable for resection or stereotactic radiotherapy (QUARTZ): results from a phase 3, non-inferiority, randomised trial. Lancet. 2016;388(10055):2004–14.

    Article  CAS  Google Scholar 

  7. Soltys SG, Adler JR, Lipani JD, Jackson PS, Choi CY, Puataweepong P, et al. Stereotactic radiosurgery of the postoperative resection cavity for brain metastases. Int J Radiat Oncol Biol Phys. 2008;70(1):187–93.

    Article  Google Scholar 

  8. Brown PD, Jaeckle K, Ballman KV, Farace E, Cerhan JH, Anderson SK, et al. Effect of Radiosurgery Alone vs Radiosurgery With Whole Brain Radiation Therapy on Cognitive Function in Patients With 1 to 3 Brain Metastases: A Randomized Clinical Trial. JAMA. 2016;316(4):401–9.

    Article  Google Scholar 

  9. Mahajan A, Ahmed S, McAleer MF, Weinberg JS, Li J, Brown P, et al. Post-operative stereotactic radiosurgery versus observation for completely resected brain metastases: a single-centre, randomised, controlled, phase 3 trial. Lancet Oncol. 2017;18(8):1040–8.

    Article  Google Scholar 

  10. Brown PD, Ballman KV, Cerhan JH, Anderson SK, Carrero XW, Whitton AC, et al. Postoperative stereotactic radiosurgery compared with whole brain radiotherapy for resected metastatic brain disease (NCCTG N107C/CEC.3): a multicentre, randomised, controlled, phase 3 trial. Lancet Oncol. 2017;18(8):1049–60.

    Article  Google Scholar 

  11. Boyd TS, Mehta MP. Stereotactic radiosurgery for brain metastases. Oncology (Williston Park). 1999;13(10):1397–409; discussion, 409–10, 413

    CAS  Google Scholar 

  12. O’Neill BP, Iturria NJ, Link MJ, Pollock BE, Ballman KV, O’Fallon JR. A comparison of surgical resection and stereotactic radiosurgery in the treatment of solitary brain metastases. Int J Radiat Oncol Biol Phys. 2003;55(5):1169–76.

    Article  Google Scholar 

  13. Zadeh G. Surgery versus radiosurgery for the treatment of single brain metastases 2013. Available from: https://clinicaltrials.gov/ct2/show/NCT01295970.

  14. Lang FF. Surgery versus stereotactic radiosurgery in the treatment of single brain metastasis: a randomized trial 2012. Available from: https://clinicaltrials.gov/ct2/show/NCT00460395.

  15. Yamamoto M, Kawabe T, Sato Y, Higuchi Y, Nariai T, Watanabe S, et al. Stereotactic radiosurgery for patients with multiple brain metastases: a case-matched study comparing treatment results for patients with 2-9 versus 10 or more tumors. J Neurosurg. 2014;121. Suppl:16–25.

    Article  Google Scholar 

  16. Kotecha R, Miller JA, Venur VA, Mohammadi AM, Chao ST, Suh JH, et al. Melanoma brain metastasis: the impact of stereotactic radiosurgery, BRAF mutational status, and targeted and/or immune-based therapies on treatment outcome. J Neurosurg. 2018;129(1):50–9.

    Article  Google Scholar 

  17. Anderson ES, Postow MA, Wolchok JD, Young RJ, Ballangrud A, Chan TA, et al. Melanoma brain metastases treated with stereotactic radiosurgery and concurrent pembrolizumab display marked regression; efficacy and safety of combined treatment. J Immunother Cancer. 2017;5(1):76.

    Article  Google Scholar 

  18. Acharya S, Mahmood M, Mullen D, Yang D, Tsien CI, Huang J, et al. Distant intracranial failure in melanoma brain metastases treated with stereotactic radiosurgery in the era of immunotherapy and targeted agents. Adv Radiat Oncol. 2017;2(4):572–80.

    Article  Google Scholar 

  19. Qian JM, Yu JB, Kluger HM, Chiang VL. Timing and type of immune checkpoint therapy affect the early radiographic response of melanoma brain metastases to stereotactic radiosurgery. Cancer. 2016;122(19):3051–8.

    Article  CAS  Google Scholar 

  20. Tawbi HA-H, Forsyth PAJ, Algazi AP, Hamid O, Hodi FS, Moschos SJ, et al. Efficacy and safety of nivolumab (NIVO) plus ipilimumab (IPI) in patients with melanoma (MEL) metastatic to the brain: Results of the phase II study CheckMate 204. J Clin Oncol. 2017;35(15 suppl):9507.

    Article  Google Scholar 

  21. Shaw E, Scott C, Souhami L, Dinapoli R, Kline R, Loeffler J, et al. Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: final report of RTOG protocol 90-05. Int J Radiat Oncol Biol Phys. 2000;47(2):291–8.

    Article  CAS  Google Scholar 

  22. Timmerman R. A phase I dose-escalation study of stereotactic radiosurgery (SRS) for brain metastasis without whole brain radiation (WBRT) 2017. Available from: http://www.utsouthwestern.edu/research/fact/detail.html?studyId=STU%20022015-106.

  23. Benedict SH, Yenice KM, Followill D, Galvin JM, Hinson W, Kavanagh B, et al. Stereotactic body radiation therapy: the report of AAPM Task Group 101. Med Phys. 2010;37(8):4078–101.

    Article  Google Scholar 

  24. Trifiletti DM, Lee CC, Winardi W, Patel NV, Yen CP, Larner JM, et al. Brainstem metastases treated with stereotactic radiosurgery: safety, efficacy, and dose response. J Neuro-Oncol. 2015;125(2):385–92.

    Article  Google Scholar 

  25. Stafford SL, Pollock BE, Leavitt JA, Foote RL, Brown PD, Link MJ, et al. A study on the radiation tolerance of the optic nerves and chiasm after stereotactic radiosurgery. Int J Radiat Oncol Biol Phys. 2003;55(5):1177–81.

    Article  Google Scholar 

  26. Kirkpatrick JP, Soltys SG, Lo SS, Beal K, Shrieve DC, Brown PD. The radiosurgery fractionation quandary: single fraction or hypofractionation? Neuro-Oncology. 2017;19(suppl 2):ii38–49.

    Article  CAS  Google Scholar 

  27. Eaton BR, Gebhardt B, Prabhu R, Shu HK, Curran WJ Jr, Crocker I. Hypofractionated radiosurgery for intact or resected brain metastases: defining the optimal dose and fractionation. Radiat Oncol. 2013;8:135.

    Article  Google Scholar 

  28. Fokas E, Henzel M, Surber G, Kleinert G, Hamm K, Engenhart-Cabillic R. Stereotactic radiosurgery and fractionated stereotactic radiotherapy: comparison of efficacy and toxicity in 260 patients with brain metastases. J Neuro-Oncol. 2012;109(1):91–8.

    Article  Google Scholar 

  29. Fowler JF, Tome WA, Fenwick JD, Mehta MP. A challenge to traditional radiation oncology. Int J Radiat Oncol Biol Phys. 2004;60(4):1241–56.

    Article  Google Scholar 

  30. Kirkpatrick JP, Wang Z, Sampson JH, McSherry F, Herndon JE 2nd, Allen KJ, et al. Defining the optimal planning target volume in image-guided stereotactic radiosurgery of brain metastases: results of a randomized trial. Int J Radiat Oncol Biol Phys. 2015;91(1):100–8.

    Article  Google Scholar 

  31. Baumert BG, Rutten I, Dehing-Oberije C, Twijnstra A, Dirx MJ, Debougnoux-Huppertz RM, et al. A pathology-based substrate for target definition in radiosurgery of brain metastases. Int J Radiat Oncol Biol Phys. 2006;66(1):187–94.

    Article  Google Scholar 

  32. Noel G, Simon JM, Valery CA, Cornu P, Boisserie G, Hasboun D, et al. Radiosurgery for brain metastasis: impact of CTV on local control. Radiother Oncol. 2003;68(1):15–21.

    Article  Google Scholar 

  33. Nataf F, Schlienger M, Liu Z, Foulquier JN, Gres B, Orthuon A, et al. Radiosurgery with or without A 2-mm margin for 93 single brain metastases. Int J Radiat Oncol Biol Phys. 2008;70(3):766–72.

    Article  Google Scholar 

  34. Andrews DW, Scott CB, Sperduto PW, Flanders AE, Gaspar LE, Schell MC, et al. Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet. 2004;363(9422):1665–72.

    Article  Google Scholar 

  35. Aoyama H, Shirato H, Tago M, Nakagawa K, Toyoda T, Hatano K, et al. Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. JAMA. 2006;295(21):2483–91.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Virginia, Radiation Oncology, Charlottesville, VA, USA

    Clayton Alonso

  2. University of Virginia Medical Center, Neurological Surgery, Charlottesville, VA, USA

    Jason P. Sheehan

  3. University of Virginia School of Medicine, Neurological Surgery, Charlottesville, VA, USA

    Jason P. Sheehan

  4. Mayo Clinic, Radiation Oncology, Mayo Clinic School of Medicine, Radiation Oncology, Jacksonville, FL, USA

    Daniel M. Trifiletti

Authors
  1. Clayton Alonso
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jason P. Sheehan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniel M. Trifiletti
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniel M. Trifiletti .

Editor information

Editors and Affiliations

  1. Mayo Clinic, Radiation Oncology, Mayo Clinic School of Medicine Radiation Oncology, Jacksonville, FL, USA

    Daniel M. Trifiletti

  2. Department of Radiation Oncology, Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH, USA

    Samuel T. Chao

  3. Sunnybrook Odette Cancer Centre, Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada

    Arjun Sahgal

  4. University of Virginia, Departments of Neurological Surgery and Radiation Oncology, Charlottesville, VA, USA

    Jason P. Sheehan

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Alonso, C., Sheehan, J.P., Trifiletti, D.M. (2019). Stereotactic Radiosurgery for Brain Metastases. In: Trifiletti, D., Chao, S., Sahgal, A., Sheehan, J. (eds) Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-16924-4_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-16924-4_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-16923-7

  • Online ISBN: 978-3-030-16924-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation