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Tumor bed radiosurgery: an emerging treatment for brain metastases

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Abstract

While typically used for treating small intact brain metastases, an increasing body of literature examining tumor bed directed stereotactic radiosurgery (SRS) is emerging. There are now over 1000 published cases treated with this approach, and the first prospective trial was recently published. The ideal sequencing of tumor bed SRS is unclear. Current approaches include, a neoadjuvant treatment before resection, alone as an adjuvant after resection, and following surgery combined with whole brain radiotherapy either as an adjuvant or salvage treatment. Based on available evidence, adjuvant stereotactic radiosurgery improves local control following surgery, reduces the number of patients who require whole brain radiotherapy, and is well tolerated. While results from published series vary, heterogeneity in both patient populations and methods of reporting results make comparisons difficult. Additional prospective data, including randomized trials are needed to confirm equivalent outcomes to the current standard of care. We review the current literature, identify areas of ongoing contention, and highlight ongoing studies.

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Authors and Affiliations

  1. Department of Radiation Oncology, Brown Cancer Center, University of Louisville, 529 S. Jackson Street, Louisville, KY, 40206, USA

    Mark J. Amsbaugh & Shiao Woo

  2. Department of Neurosurgery, University of Louisville, Louisville, USA

    Warren Boling

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  1. Mark J. Amsbaugh
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Correspondence to Mark J. Amsbaugh.

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Amsbaugh, M.J., Boling, W. & Woo, S. Tumor bed radiosurgery: an emerging treatment for brain metastases. J Neurooncol 123, 197–203 (2015). https://doi.org/10.1007/s11060-015-1789-y

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