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Radiosurgery for brain metastases: who may not benefit?
E Weltman1, J V Salvajoli, R A Brandt
1Department of Radiation Oncology, Hospital Israelita Albert Einstein, Sao Paulo, Brazil. weltman@einstein.br
International Journal of Radiation Oncology, Biology, Physics
|December 1, 2001
Summary
Stereotactic radiosurgery (SRS) may not benefit patients with brain metastases and a Score Index for Stereotactic Radiosurgery for Brain Metastases (SIR) of 5 or lower, as they have a median survival of less than 6 months. This finding helps identify patients unlikely to benefit from SRS.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Brain metastases present a significant challenge in cancer care.
- Stereotactic radiosurgery (SRS) is a common treatment for brain metastases.
- Predictive tools are needed to optimize patient selection for SRS.
Purpose of the Study:
- To identify patients with brain metastases for whom SRS may not be beneficial.
- To evaluate the prognostic value of the Score Index for Stereotactic Radiosurgery for Brain Metastases (SIR).
Main Methods:
- Retrospective analysis of 87 patients with brain metastases treated with SRS.
- Stratification of patients using the SIR score (0-5 and 6-10).
- Survival analysis using Cox and Kaplan-Meier models, compared by log-rank test.
Main Results:
- Overall median survival after SRS was 6.88 months.
- Patients with SIR 0-5 had a significantly shorter median survival of 4.52 months (p=0.0001).
- The 6-month survival probability for the SIR 0-5 group was 35.6%.
Conclusions:
- Patients with brain metastases and an SIR of 5 or lower have a median survival of less than 6 months post-SRS.
- SRS may not be the optimal treatment for this subgroup of patients.
- The SIR score is a valuable tool for predicting outcomes in patients with brain metastases undergoing SRS.