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Stereotactic radiosurgery for brain metastases.

T S Boyd¹, M P Mehta

¹Department of Human Oncology, University of Wisconsin Medical School, Madison, USA.

Oncology (Williston Park, N.Y.)

|November 5, 1999

Summary

Stereotactic radiosurgery offers effective local control for brain metastases, with survival comparable to surgery. Key survival factors include limited lesions and good performance status.

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Area of Science:

Neurosurgery
Radiation Oncology
Oncology

Background:

Brain metastases are a common indication for stereotactic radiosurgery.
Over 100,000 patients worldwide have undergone this procedure for intracranial lesions.

Purpose of the Study:

To summarize management issues for brain metastases.
To analyze radiosurgery outcomes from existing studies.

Main Methods:

Analysis of 21 independent reports on Gamma Knife or linear accelerator radiosurgery.
Inclusion of over 1,700 patients and 2,700 lesions.

Main Results:

Average local control rate of 83% and median survival of 9.6 months.
Prognostic factors for survival: <3 lesions, controlled extracranial disease, Karnofsky Performance Score (KPS).
Emerging dose-response relationship, particularly for >= 18 Gy.

Conclusions:

Radiosurgery outcomes are comparable to surgical results.
The role of whole-brain radiotherapy in conjunction with radiosurgery requires further investigation.
Ongoing randomized trials are crucial for validating these findings.

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