Abstract
Purpose
Preoperative stereotactic radiosurgery (SRS) of brain metastases may achieve similar local control and better leptomeningeal control rates than postoperative fractionated stereotactic radiotherapy (FSRT) in patients treated with elective metastasectomy. To plan a multicentre trial of preoperative SRS compared with postoperative FSRT, a survey of experts was conducted to determine current practice.
Methods
A survey with 15 questions was distributed to the DEGRO Radiosurgery and Stereotactic Radiotherapy Working Group. Participants were asked under what circumstances they offered SRS, FSRT, partial and/or whole brain radiotherapy before or after resection of a brain metastasis, as well as the feasibility of preoperative stereotactic radiosurgery and neurosurgical resection within 6 days.
Results
Of 25 participants from 24 centres, 22 completed 100% of the questions. 24 respondents were radiation oncologists and 1 was a neurosurgeon. All 24 centres have one or more dedicated radiosurgery platform and all offer postoperative FSRT. Preoperative SRS is offered by 4/24 (16.7%) centres, and 9/24 (37.5%) sometimes recommend single-fraction postoperative SRS. Partial brain irradiation is offered by 8/24 (33.3%) centres and 12/24 (50%) occasionally recommend whole-brain irradiation. Two centres are participating in clinical trials of preoperative SRS. SRS techniques and fractionation varied between centres.
Conclusion
All responding centres currently offer postoperative FSRT after brain metastasectomy. Approximately one third offer single-fraction postoperative SRS and four already perform preoperative SRS. With regard to potential co-investigators, 18 were identified for the PREOP‑2 multicentre trial, which will randomise between preoperative SRS and postoperative FSRT.
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Change history
14 November 2022
A Correction to this paper has been published: https://doi.org/10.1007/s00066-022-02021-1
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All authors contributed to study conception and design. Material preparation, data collection and analysis were performed by S. Rogers. The first draft of the manuscript was written by S. Rogers and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Conflict of interest
S. Rogers and J. Boström have received Speaker’s Honoraria from Brainlab. O. Blanck is a section editor for the journal Strahlentherapie und Onkologie. B. Baumert, D. Böhmer, R. Engenhart-Cabillic, E. Ermis, S. Exner, M. Guckenberger, D. Habermehl, H. Hemmatazad, G. Henke, F. Lohaus, S. Lux, S. Mai, D. Minasch, A. Rezazadeh, C. Steffal, S. Temming, A. Wittig, C. Zweifel, O. Riesterer and S. Combs declare that they have no competing interests.
Additional information
The data were presented in part at DEGRO 2021.
The original online version of this article was revised: In this article the author name S.E. Combs was incorrectly written as S. Combs.
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Rogers, S., Baumert, B., Blanck, O. et al. Stereotactic radiosurgery and radiotherapy for resected brain metastases: current pattern of care in the Radiosurgery and Stereotactic Radiotherapy Working Group of the German Association for Radiation Oncology (DEGRO). Strahlenther Onkol 198, 919–925 (2022). https://doi.org/10.1007/s00066-022-01991-6
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DOI: https://doi.org/10.1007/s00066-022-01991-6