How many metastases can be treated with radiosurgery?

Area of Science:

• Neurosurgery
• Oncology
• Radiology

Background:

• Brain metastases represent a significant challenge in cancer care.
• Gamma Knife radiosurgery (GKRS) is a key treatment modality for brain metastases.
• Understanding factors influencing outcomes after GKRS is crucial for patient management.

Purpose of the Study:

• To evaluate postradiosurgical treatment outcomes in a large cohort of patients with brain metastases treated with GKRS.
• To specifically analyze the impact of multiple lesions on survival after GKRS.
• To identify factors affecting survival duration in patients undergoing GKRS for brain metastases.

Main Methods:

• Retrospective analysis of 1,676 consecutive patients treated with GKRS for brain metastases.
• Kaplan-Meier method used to assess survival based on primary cancer type and number of lesions.
• Statistical comparison of survival times across different tumor burden groups.

Main Results:

• Overall median survival was 9.0 months for females and 5.9 months for males.
• Survival time significantly decreased with an increasing number of brain metastases (p < 0.0001).
• Despite the impact of tumor number, approximately 85% of deaths were due to non-brain disease progression.

Conclusions:

• While the number of brain metastases treated with GKRS significantly impacts survival, it is not the sole determinant of outcome.
• The majority of patients with brain metastases treated with GKRS succumb to systemic disease or other complications rather than local brain progression.
• Further research should explore strategies to improve overall survival by addressing systemic disease burden.