Skip to main content
SpringerLink
Log in
Book cover

Tumors of the Central Nervous System, Volume 12 pp 345–357Cite as

Brain Metastases: The Application of Stereotactic Radiosurgery and Technological Advances

  • Chapter
  • First Online:

  • 1348 Accesses

Part of the book series: Tumors of the Central Nervous System ((TCNS,volume 12))

Abstract

The purpose of this chapter is to provide a comprehensive review of the use of stereotactic radiosurgery (SRS) in patients with brain metastases. We focus only on level 1 evidence from randomized controlled trials and meta-analyses. A discussion on SRS technology follows and focuses on Gamma-Knife, Cyberknife, and modern linac-based SRS technologies.

This is a preview of subscription content, 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   129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   169.99
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

Learn about institutional subscriptions

References

  • Andrews DW, Scott CB, Sperduto PW, Flanders AE, Gaspar LE, Schell MC, Werner-Wasik M, Demas W, Ryu J, Bahary JP, Souhami L, Rotman M, Mehta MP, Curran WJ Jr (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 

  • Aoyama H, Shirato H, Tago M, Nakagawa K, Toyoda T, Hatano K, Kenjyo M, Oya N, Hirota S, Shioura H, Kunieda E, Inomata T, Hayakawa K, Katoh N, Kobashi G (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  CAS  PubMed  Google Scholar 

  • Brown PD, Kee AY, Eshleman JS, Fiveash JB (2009) Adjuvant whole brain radiotherapy: strong emotions decide but rationale studies are needed: in regard to Brown et al. (Int J Radiat Oncol Biol Phys 2008;70:1305–1309). In reply to Drs. Larson and Sahgal. Int J Radiat Oncol Biol Phys 75:316–317

    Article  PubMed  Google Scholar 

  • Chang EL, Wefel JS, Hess KR, Allen PK, Lang FF, Kornguth DG, Arbuckle RB, Swint JM, Shiu AS, Maor MH, Meyers CA (2009) Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial. Lancet Oncol 10:1037–1044

    Article  PubMed  Google Scholar 

  • Davidson MT, Masucci GL, Follwell M, Blake SJ, Xu W, Moseley DJ, Sanghera P, Wong CS, Perry J, Tsao M, Sahgal A (2012) Single arc volumetric modulated arc therapy for complex brain gliomas: is there an advantage as compared to intensity modulated radiotherapy or by adding a partial arc? Technol Cancer Res Treat 11:211–220

    Article  CAS  PubMed  Google Scholar 

  • Dieterich S, Gibbs IC (2011) The CyberKnife in clinical use: current roles, future expectations. Front Radiat Ther Oncol 43:181–194

    Article  PubMed  Google Scholar 

  • Follwell MJ, Khu KJ, Cheng L, Xu W, Mikulis DJ, Millar BA, Tsao MN, Laperriere NJ, Bernstein M, Sahgal A (2012) Volume specific response criteria for brain metastases following salvage stereotactic radiosurgery and associated predictors of response. Acta Oncol 51:629–635

    Article  PubMed  Google Scholar 

  • Gaspar L, Scott C, Rotman M, Asbell S, Phillips T, Wasserman T, McKenna WG, Byhardt R (1997) Recursive partitioning analysis (RPA) of prognostic factors in three radiation therapy oncology group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 37:745–751.33

    Article  CAS  PubMed  Google Scholar 

  • Gondi V, Tolakanahalli R, Mehta MP, Tewatia D, Rowley H, Kuo JS, Khuntia D, Tomé WA (2010) Hippocampal-sparing whole-brain radiotherapy: a “How-To” technique using helical tomotherapy and linear accelerator-based intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys 78:1244–1252

    Article  PubMed Central  PubMed  Google Scholar 

  • Katz J, Knisely J, Ghaly M, Shulder M (2012) Adjuvant tumor bed radiosurgery following surgical resection of intracranial metastases. J. Neurooncol (in press)

    Google Scholar 

  • Kim YJ, Cho KH, Kim JY, Lim YK, Min HS, Lee SH, Kim HJ, Gwak HS, Yoo H, Lee SH (2011) Single-dose versus fractionated stereotactic radiotherapy for brain metastases. Int J Radiat Oncol Biol Phys 81:483–489

    Article  PubMed  Google Scholar 

  • Kocher M, Soffietti R, Abacioglu U, Villa S, Fauchon F, Baumert BG, Fariselli L, Tzuk-Shina T, Kortmann RD, Carrie C, Ben Hassel M, Kouri M, Valeinis E, van den Berge D, Collette S, Collette L, Mueller RP (2010) 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 29:134–141

    Article  PubMed Central  PubMed  Google Scholar 

  • Kondziolka D, Patel A, Lunsford LD, Kassam A, Flickinger JC (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  CAS  PubMed  Google Scholar 

  • Ma L, Petti P, Wang B, Descovich M, Chuang C, Barani IJ, Kunwar S, Shrieve DC, Sahgal A, Larson DA (2011) Apparatus dependence of normal brain tissue dose in stereotactic radiosurgery for multiple brain metastases. J Neurosurg 114:1580–1584

    Article  PubMed  Google Scholar 

  • Mintz AP, Cairncross JG (1998) Treatment of a single brain metastasis: the role of radiation following surgical resection. JAMA 280:1527–1529

    Article  CAS  PubMed  Google Scholar 

  • Muacevic A, Wowra B, Siefert A, Tonn JC, Steiger HJ, Kreth FW (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 87:299–307

    Article  PubMed  Google Scholar 

  • Murphy M (2009) Intrafraction geometric uncertainties in frameless image-guided radiosurgery. Int J Radiat Oncol Biol Phys 73:1364–1368

    Article  PubMed  Google Scholar 

  • Nath SK, Lawson JD, Simpson DR, Vanderspek L, Wang JZ, Alksne JF, Ciacci J, Mundt AJ, Murphy KT (2010) Single-isocenter frameless intensity-modulated stereotactic radiosurgery for simultaneous treatment of multiple brain metastases: clinical experience. Int J Radiat Oncol Biol Phys 78:91–97

    Article  PubMed  Google Scholar 

  • Noordijk EM, Vecht CJ, Haaxma-Reiche H, Padberg GW, Voormolen JH, Hoekstra FH, Tans JT, Lambooij N, Metsaars JA, Wattendorff AR, Brand R, Hermans J (1994) The choice of treatment of single brain metastasis should be based on extracranial tumor activity and age. Int J Radiat Oncol Biol Phys 29:711–717

    Article  CAS  PubMed  Google Scholar 

  • Patchell RA, Tibbs PA, Walsh JW, Dempsey RJ, Maruyama Y, Kryscio RJ, Markesbery WR, Macdonald JS, Young B (1990) A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 322:494–500

    Article  CAS  PubMed  Google Scholar 

  • Patchell RA, Tibbs PA, Regine WF, Dempsey RJ, Mohiuddin M, Kryscio RJ, Markesbery WR, Foon KA, Young B (1998) Postoperative radiotherapy in the treatment of single metastases to the brain: a randomized trial. JAMA 280:1485–1489

    Article  CAS  PubMed  Google Scholar 

  • Roberge D, Souhami L (2010) Tumor bed radiosurgery following resection of brain metastases: a review. Technol Cancer Res Treat 9:597–602

    Article  PubMed  Google Scholar 

  • Roberge D, Parney I, Brown PD (2012) Radiosurgery to the postoperative surgical cavity: who needs evidence? Int J Radiat Oncol Biol Phys 83:486–493

    Article  PubMed  Google Scholar 

  • Ruschin M, Nayebi N, Carlsson P, Brown K, Tamerou M, Li W, Laperriere N, Sahgal A, Cho YB, Ménard C, Jaffray D (2010) Performance of a novel repositioning head frame for Gamma Knife perfexion and image-guided linac-based intracranial stereotactic radiotherapy. Int J Radiat Oncol Biol Phys 78:306–313

    Article  PubMed  Google Scholar 

  • Ruschin M, Komljenovic PT, Ansell S, Menard C, Bootsma G, Cho YB, Chung C, Jaffray D (2013) Cone beam computed tomography image guidance system for a dedicated intracranial radiosurgery treatment unit. Int J Radiat Oncol Biol Phys 85:243–250

    Article  PubMed  Google Scholar 

  • Sahgal A, Ma L, Chang E, Shiu A, Larson DA, Laperriere N, Yin FF, Tsao M, Menard C, Basran P, Létourneau D, Heydarian M, Beachey D, Shukla V, Cusimano M, Hodaie M, Zadeh G, Bernstein M, Schwartz M (2009) Advances in technology for intracranial stereotactic radiosurgery. Technol Cancer Res Treat 8:271–280

    Article  PubMed  Google Scholar 

  • Sahgal A, Soliman H, Larson DA (2012) Whole-brain radiation therapy of brain metastasis. Prog Neurol Surg 25:82–95

    Article  PubMed  Google Scholar 

  • Slotman B, Faivre-Finn C, Kramer G, Rankin E, Snee M, Hatton M, Postmus P, Collette L, Musat E, Senan S, EORTC Radiation Oncology Group and Lung Cancer Group (2007) Prophylactic cranial irradiation in extensive small-cell lung cancer. N Engl J Med 357:664–672

    Article  CAS  PubMed  Google Scholar 

  • Sperduto PW, Berkey B, Gaspar LE, Mehta M, Curran W (2008) A new prognostic index and comparison to three other indices for patients with brain metastases: an analysis of 1,960 patients in the RTOG database. Int J Radiat Oncol Biol Phys 70:510–514

    Article  PubMed  Google Scholar 

  • Sperduto PW, Chao ST, Sneed PK, Luo X, Suh J, Roberge D, Bhatt A, Jensen AW, Brown PD, Shih H, Kirkpatrick J, Schwer A, Gaspar LE, Fiveash JB, Chiang V, Knisely J, Sperduto CM, Mehta M (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 

  • Sun A, Bae K, Gore EM, Movsas B, Wong SJ, Meyers CA, Bonner JA, Schild SE, Gaspar LE, Bogart JA, Werner-Wasik M, Choy H (2011) Phase III trial of prophylactic cranial irradiation compared with observation in patients with locally advanced non-small-cell lung cancer: neurocognitive and quality-of-life analysis. J Clin Oncol 29:279–286

    Article  PubMed Central  PubMed  Google Scholar 

  • Tanyi JA, Kato CM, Chen Y, Chen Z, Fuss M (2011) Impact of the high-definition multileaf collimator on linear accelerator-based intracranial stereotactic radiosurgery. Br J Radiol 84:629–638

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Tsao M, Xu W, Sahgal A (2012a) A meta-analysis evaluating stereotactic radiosurgery, whole-brain radiotherapy, or both for patients presenting with a limited number of brain metastases. Cancer 118:2486–2493

    Article  PubMed  Google Scholar 

  • Tsao MN, Lloyd N, Wong RK, Chow E, Rakovitch E, Laperriere N, Xu W, Sahgal A (2012b) Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases. Cochrane Database Syst Rev 4:CD003869

    PubMed  Google Scholar 

  • Vecht CJ, Haaxma-Reiche H, Noordijk EM, Padberg GW, Voormolen JH, Hoekstra FH, Tans JT, Lambooij N, Metsaars JA, Wattendorff AR, Brand R, Hermans J (1993) Treatment of single brain metastasis: radiotherapy alone or combined with neurosurgery? Ann Neurol 33:583–590

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, The Doug and Nancy Barnhart Cancer Center, Sharp Chula Vista Medical Center, Chula Vista, CA, USA

    Siavash Jabbari

  2. Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA

    Lijun Ma & David A. Larson

  3. Department of Radiation Oncology, Hall-Edwards Radiotherapy Research Group, University Hospital Birmingham, Birmingham, UK

    Paul Sanghera

  4. Department of Radiation Oncology, University of Southern California, Los Angeles, CA, USA

    Eric L. Chang

  5. Department of Radiation Oncology, Cleveland Clinic, Cleveland, OH, USA

    Sam T. Chao

  6. Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada

    Alex Karotki, Hany Soliman & James Perry

  7. Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA

    Simon S. Lo

  8. Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada

    Daniel Letourneau

  9. Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Princess Margaret Hospital, University of Toronto, 610 University Avenue, M6G 2M5, Toronto, ON, Canada

    Arjun Sahgal

Authors
  1. Siavash Jabbari
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lijun Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paul Sanghera
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eric L. Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sam T. Chao
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Alex Karotki
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hany Soliman
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Simon S. Lo
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Daniel Letourneau
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. James Perry
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. David A. Larson
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Arjun Sahgal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Arjun Sahgal .

Editor information

Editors and Affiliations

  1. Department of Biological Sciences, Kean University, Room 213, Library Building, Union, New Jersey, USA

    M.A. Hayat

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Jabbari, S. et al. (2014). Brain Metastases: The Application of Stereotactic Radiosurgery and Technological Advances. In: Hayat, M. (eds) Tumors of the Central Nervous System, Volume 12. Tumors of the Central Nervous System, vol 12. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7217-5_30

Download citation

  • DOI: https://doi.org/10.1007/978-94-007-7217-5_30

  • Published:

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-007-7216-8

  • Online ISBN: 978-94-007-7217-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation