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Stereotactic radiosurgery for the treatment of brain metastases; results from a single institution experience

Irish Journal of Medical Science Aims and scope Submit manuscript

Abstract

Background

Stereotactic radiosurgery is frequently used for the treatment of brain metastases. This study provides a retrospective evaluation of patients with secondary lesions of the brain treated with stereotactic radiosurgery (SRS) at our institution.

Aims

To provide outcome data from a single institutional experience with SRS and identify any significant prognostic factors in the cohort.

Methods

Sixty-seven patients received first time SRS to 86 intracranial metastases between 2007 and 2010. Sixteen patients were excluded from this study due to the absence of post-treatment neuroimaging, resulting in 51 patients with 64 treated lesions. Of these patients, 37 (72.5 %) received SRS electively, while 14 (27.5 %) received salvage SRS after brain metastasis progression following whole brain radiotherapy.

Results

Median survival for the entire group was 15 months from the date of radiosurgery. Patients without active extracranial disease had statistically significant survival time than those with active extracranial disease (P = 0.03). 45 (70.3 %) lesions achieved local tumour control in 34 patients (66.7 %) with a mean follow-up period of 10.7 months (range 1.7–33.6 months, 95 % confidence interval 6.6–9.8 months).

Conclusions

The results reported in this study equate to those reported in other series consolidating SRS as an effective treatment option with few serious complications. Developments in systemic disease control will see further improvements in overall survival.

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References

  1. Johnson JD, Young B (1996) Demographics of brain metastasis. Neurosurg Clin N Am 7:337–344

    PubMed  CAS  Google Scholar 

  2. Mehta MP, Tsao MN, Whelan TJ et al (2005) The American Society for Therapeutic Radiology and Oncology (ASTRO) evidence-based review of the role of radiosurgery for brain metastases. Int J Radiat Oncol Biol Phys 63:37–46

    Article  PubMed  Google Scholar 

  3. Borgelt B, Gelber R, Kramer S et al (1989) The palliation of brain metastases: final results of the first two studies by the Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys 16:669–673

    Article  Google Scholar 

  4. Patchell RA, Tibbs PA, Walsh JW et al (1990) A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 322:494–500

    Article  PubMed  CAS  Google Scholar 

  5. Leksell L (1951) The stereotaxic method and radiosurgery of the brain. Acta Chir Scand 102:316–319

    PubMed  CAS  Google Scholar 

  6. Steiner L, Leksell L, Greitz T (1972) Stereotaxic radiosurgery for cerebral arteriovenous malformations. Acta Chir Scand 138:459–464

    PubMed  CAS  Google Scholar 

  7. Gaspar L, Scott C, Rotman M et al (1997) Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 37:745–751

    Article  PubMed  CAS  Google Scholar 

  8. Andrews DW, Scott C, Sperduto PW et al (2004) 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 363:1665–1672

    Article  PubMed  Google Scholar 

  9. Rutigliano MJ, Lunsford LD, Kondziolka D et al (1995) The cost effectiveness of stereotactic radiosurgery versus surgical resection in the treatment of solitary metastatic brain tumors. Neurosurgery 37:445–455

    Article  PubMed  CAS  Google Scholar 

  10. Kurtz JM, Gelber R, Brady LW et al (1981) The palliation of brain metastases in a favourable patient population: a randomized clinical trial by the Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys 48:1749–1895

    Google Scholar 

  11. Flickenger JC, Kondziolka D, Lunsford LD et al (1994) A multi-institutional experience with stereotactic radiosurgery for solitary brain metastasis. Int J Radiat Oncol Biol Phys 28:797–802

    Article  Google Scholar 

  12. Breneman JC, Warnick RE, Albright RE (1997) Stereotactic radiosurgery for the treatment of brain metastases. Cancer 79:551–557

    Article  PubMed  CAS  Google Scholar 

  13. Kim YS, Kondziolka D, Flickenger JC (1997) Stereotactic radiosurgery for patients with nonsmall cell lung carcinoma metastatic to the brain. Cancer 80:2075–2083

    Article  PubMed  CAS  Google Scholar 

  14. Sperduto PW, Chao ST, Sneed PK et al (2010) Diagnosis specific prognostic factors, indexes and treatment outcomes for patients with newly diagnosed brain metastases: a multi-institutional analysis of 4,259 patients. Int J Radiat Oncol Biol Phys 77:655–661

    Article  PubMed  Google Scholar 

  15. Kondzoilka D, Patel A, Lunsford LD (1999) Stereotactic radiosurgery plus whole brain radiotherapy versus radiotherapy alone for patients with multiple brain metastases. Int J Radiat Oncol Biol Phys 45:427–434

    Article  Google Scholar 

  16. Wang LG, Guo Y, Zhang X (2002) Brain metastasis: experience of the Xi-Jing hospital. Stereotact Funct Neurosurg 78:70–83

    Article  PubMed  Google Scholar 

  17. Sanghavi SN, Miranpuri SS, Chappell R (2001) Radiosurgery for patients with brain metastasis: a multi-institutional analysis, stratified by the RTOG recursive partitioning analysis method. Int J Radiat Oncol Biol Phys 51:426–434

    Article  PubMed  CAS  Google Scholar 

  18. Sperduto PW, Kased N, Roberge D et al (2012) Effect of tumor subtype on survival and the graded prognostic assessment for patients with breast cancer and brain metastases. Int J Radiat Oncol Biol Phys 82(5):2111–2117

    Article  PubMed  Google Scholar 

  19. Aoyama H, Shirato H, Tago M et al (2006) Stereotactic radiosurgery plus whole-brain radiation therapy vs. stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. JAMA 295:2483–2491

    Article  PubMed  CAS  Google Scholar 

  20. Muacevic A, Wowra B, Siefert A et al (2008) Microsurgery plus whole brain irradiation versus Gamma Knife surgery alone for treatment of single metastases to the brain: a randomized controlled multicentre phase III trial. J Neurooncol 87(3):299–307

    Article  PubMed  Google Scholar 

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Correspondence to D. Burke.

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Burke, D., Mascott, C., Rock, L. et al. Stereotactic radiosurgery for the treatment of brain metastases; results from a single institution experience. Ir J Med Sci 182, 481–485 (2013). https://doi.org/10.1007/s11845-013-0918-x

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  • DOI: https://doi.org/10.1007/s11845-013-0918-x

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