Solitary brain metastasis: radiosurgery in lieu of microsurgery in 32 patients

Thirty-two consecutive patients with 34 small brain metastases underwent boost stereotactic radiosurgery using the first North American Gamma Unit between May 1988 and July 1990. The majority of tumors (n = 24; 71%) were considered resistant to conventional, fractionated irradiation (malignant melanoma, n = 13; non-small cell lung carcinoma, n = 7; renal cell carcinoma, n = 4). During the follow-up period (median = 10 months; range = 1.5-15 months) no patient suffered a complication of radiosurgical treatment, and no patient died from a radiosurgically-treated metastasis. Shrinkage or growth-arrest was documented in 20 of 23 patients (87%) available for follow-up. Median survival after treatment was 10 months.