Radiosurgery for metastatic brain tumors

Area of Science:

• Neurosurgery
• Radiation Oncology
• Oncology

Background:

• Stereotactic radiosurgery (SRS) is a precise radiation technique for small brain tumors.
• It offers good tumor control and preserves neurological function in patients with brain metastases.
• Current treatment options include surgery, SRS, and whole-brain radiation therapy (WBRT).

Purpose of the Study:

• To review the efficacy and indications of SRS for brain metastases.
• To compare different SRS delivery techniques, Gamma Knife (GK) and linear accelerator (LINIAC)-based SRS.
• To evaluate the necessity and impact of WBRT in conjunction with SRS.

Main Methods:

• Literature review of retrospective and prospective studies on SRS for brain metastases.
• Comparison of Gamma Knife (GK) and LINIAC-based SRS techniques and applications.
• Analysis of data regarding the role of WBRT before or after SRS.

Main Results:

• SRS provides effective local control for small brain metastases, preventing neurological death.
• WBRT before or after SRS may improve local control and reduce new lesions, but does not improve survival.
• Significant differences exist between GK and LINIAC SRS in technique and clinical application.

Conclusions:

• SRS is a valuable treatment for brain metastases, particularly for limited small tumors in patients with good prognosis.
• The choice between GK and LINIAC SRS depends on specific clinical scenarios.
• A new treatment strategy for brain metastases is proposed based on current evidence and experience.