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Radiosurgery for large brain metastases.

Jung Ho Han¹, Dong Gyu Kim, Hyun-Tai Chung

¹Department of Neurosurgery, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.

International Journal of Radiation Oncology, Biology, Physics

|October 25, 2011

Summary

Radiosurgery is effective for large brain metastases, offering comparable outcomes to surgery. However, potential radiation-related toxicities require careful consideration in treatment decisions for brain tumors.

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Area of Science:

Neurosurgery
Radiation Oncology
Oncology

Background:

Large brain metastases pose significant treatment challenges.
Radiosurgery is an evolving treatment modality for intracranial lesions.
Assessing the efficacy and safety of radiosurgery for large brain metastases is crucial.

Purpose of the Study:

To evaluate the efficacy and safety of radiosurgery in patients with large brain metastases (>14 cm³).
To identify factors associated with overall survival after radiosurgery for large brain metastases.

Main Methods:

Retrospective analysis of 80 patients with large brain metastases treated with radiosurgery between 1998 and 2009.
Data collected included patient demographics, disease characteristics, treatment details, and outcomes.

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Statistical analysis was performed to determine survival rates and identify prognostic factors.

Main Results:

The median survival time was 7.9 months, with a 1-year survival rate of 39.2%.
Functional improvement or maintenance of independent status was observed in 60% and 25% of patients, respectively.
Control of primary disease, marginal dose ≥11 Gy, and tumor volume ≥26 cm³ were associated with improved survival. Radiation-related toxicities occurred in 18.8% of patients.

Conclusions:

Radiosurgery demonstrates comparable efficacy to surgery for large brain metastases.
The incidence of radiation-related toxicities necessitates careful consideration when selecting treatment modalities.
Further research may optimize radiosurgery protocols for better outcomes in large brain metastases.