Skip to main content

Secondary Malignant (Metastases)

  • Chapter
  • First Online:
Hypofractionated and Stereotactic Radiation Therapy

Abstract

Brain metastasis is the most common indication for stereotactic radiosurgery (SRS). SRS is a safe and effective treatment modality for patients with good performance status and limited number of brain metastases. In addition, SRS serves as an adjuvant therapy for resected brain lesions. Accumulating studies also support the use of hypofractionated stereotactic radiotherapy (HSRT), or Fractionated stereotactic radiotherapy (FSRT) delivering 27–35 Gy in 3–5 fractions for relatively large brain lesions and resection beds.

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

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight 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. Sperduto PW, et al. Estimating survival in patients with lung cancer and brain metastases: an update of the graded prognostic assessment for lung cancer using molecular markers (lung-molGPA). JAMA Oncol. 2017;3:827–31.

    Article  PubMed  Google Scholar 

  2. Sperduto PW, et al. Estimating survival in melanoma patients with brain metastases: an update of the graded prognostic assessment for melanoma using molecular markers (melanoma-molGPA). Int J Radiat Oncol Biol Phys. 2017;99:812–6.

    Article  CAS  PubMed  Google Scholar 

  3. Sperduto PW, et al. Summary report on the graded prognostic assessment: an accurate and facile diagnosis-specific tool to estimate survival for patients with brain metastases. J Clin Oncol Off J Am Soc Clin Oncol. 2012;30:419–25.

    Article  Google Scholar 

  4. Mulvenna P, 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 Lond Engl. 2016;388:2004–14.

    Article  CAS  Google Scholar 

  5. Yamamoto M, et al. Stereotactic radiosurgery for patients with multiple brain metastases (JLGK0901): a multi-institutional prospective observational study. Lancet Oncol. 2014;15:387–95.

    Article  PubMed  Google Scholar 

  6. Chang EL, et al. Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial. Lancet Oncol. 2009;10:1037–44.

    Article  PubMed  Google Scholar 

  7. Brown PD, 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;316:401–9.

    Article  PubMed  PubMed Central  Google Scholar 

  8. McKay WH, et al. Repeat stereotactic radiosurgery as salvage therapy for locally recurrent brain metastases previously treated with radiosurgery. J Neurosurg. 2017;127:148–56. https://doi.org/10.3171/2016.5.JNS153051.

    Article  PubMed  Google Scholar 

  9. Shaw E, 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;47:291–8.

    Article  CAS  PubMed  Google Scholar 

  10. Manning MA, et al. Hypofractionated stereotactic radiotherapy as an alternative to radiosurgery for the treatment of patients with brain metastases. Int J Radiat Oncol Biol Phys. 2000;47:603–8.

    Article  CAS  PubMed  Google Scholar 

  11. Aoyama H, et al. Hypofractionated stereotactic radiotherapy alone without whole-brain irradiation for patients with solitary and oligo brain metastasis using noninvasive fixation of the skull. Int J Radiat Oncol Biol Phys. 2003;56:793–800.

    Article  PubMed  Google Scholar 

  12. Ernst-Stecken A, Ganslandt O, Lambrecht U, Sauer R, Grabenbauer G. Phase II trial of hypofractionated stereotactic radiotherapy for brain metastases: results and toxicity. Radiother Oncol. 2006;81:18–24.

    Article  PubMed  Google Scholar 

  13. Murai T, et al. Fractionated stereotactic radiotherapy using CyberKnife for the treatment of large brain metastases: a dose escalation study. Clin Oncol( R Coll Radiol). 2014;26:151–8.

    Article  CAS  Google Scholar 

  14. Minniti G, et al. Multidose stereotactic radiosurgery (9 Gy × 3) of the postoperative resection cavity for treatment of large brain metastases. Int J Radiat Oncol Biol Phys. 2013;86:623–9.

    Article  PubMed  Google Scholar 

  15. Brown PD, 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;18:1049–60.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Mahajan A, et al. Post-operative stereotactic radiosurgery versus observation for completely resected brain metastases: a single-Centre, randomised, controlled, phase 3 trial. Lancet Oncol. 2017;18:1040–8.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Miller JA, et al. Association between radiation necrosis and tumor biology after stereotactic radiosurgery for brain metastasis. Int J Radiat Oncol Biol Phys. 2016;96(5):1060–9. https://doi.org/10.1016/j.ijrobp.2016.08.039.

    Article  PubMed  Google Scholar 

  18. Nabors LB, et al. Central nervous system cancers, version 1.2015. J Natl Compr Cancer Netw. 2015;13:1191–202.

    Article  CAS  Google Scholar 

  19. Andrews DW, 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 Lond. Engl. 2004;363:1665–72.

    Google Scholar 

  20. Aoyama H, et al. Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. JAMA. 2006;295:2483–91.

    Article  CAS  PubMed  Google Scholar 

  21. Kocher M, et al. Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases: results of the EORTC 22952-26001 study. J Clin Oncol Off J Am Soc Clin Oncol. 2011;29:134–41.

    Article  Google Scholar 

  22. Likhacheva A, et al. Predictors of survival in contemporary practice after initial radiosurgery for brain metastases. Int J Radiat Oncol Biol Phys. 2013;85:656–61.

    Article  PubMed  Google Scholar 

  23. Ammirati M, Kshettry VR, Lamki T, Wei L, Grecula JC. A prospective phase II trial of fractionated stereotactic intensity modulated radiotherapy with or without surgery in the treatment of patients with 1 to 3 newly diagnosed symptomatic brain metastases. Neurosurgery. 2014;74:586–94; discussion 594.

    Article  PubMed  Google Scholar 

  24. Brennan C, et al. A phase 2 trial of stereotactic radiosurgery boost after surgical resection for brain metastases. Int J Radiat Oncol Biol Phys. 2014;88:130–6.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Jensen CA, et al. Cavity-directed radiosurgery as adjuvant therapy after resection of a brain metastasis. J Neurosurg. 2011;114:1585–91.

    Article  PubMed  Google Scholar 

  26. Choi CYH, et al. Stereotactic radiosurgery of the postoperative resection cavity for brain metastases: prospective evaluation of target margin on tumor control. Int J Radiat Oncol Biol Phys. 2012;84:336–42.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Moon, D.H., Zagar, T.M. (2018). Secondary Malignant (Metastases). In: Kaidar-Person, O., Chen, R. (eds) Hypofractionated and Stereotactic Radiation Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-92802-9_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-92802-9_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-92800-5

  • Online ISBN: 978-3-319-92802-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics