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Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy
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Stereotactic radiosurgery for brain metastases.

Toru Serizawa1, Yoshinori Higuchi, Osamu Nagano

  • 1Tokyo Gamma Unit Center, Tsukiji Neurological Clinic, 1-9-9 Tsukiji, Chuo-ku, Tokyo, Japan.

Neurosurgery Clinics of North America
|October 8, 2013
PubMed
Summary

Gamma Knife radiosurgery (GKS) effectively manages new brain metastases without upfront whole-brain radiation. Salvage GKS controls distant lesions, but ongoing MRI surveillance and treatment are crucial for survival and quality of life.

Keywords:
Brain metastasesGamma Knife radiosurgeryStereotactic radiosurgeryWhole-brain radiation therapy

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Area of Science:

  • Neurosurgery
  • Radiation Oncology
  • Oncology

Background:

  • Brain metastases are a common complication of systemic cancer.
  • Whole-brain radiation therapy (WBRT) has been a standard treatment but can cause neurotoxicity.
  • Alternative or adjuvant treatments are needed to improve outcomes for patients with brain metastases.

Purpose of the Study:

  • To evaluate the efficacy and safety of Gamma Knife radiosurgery (GKS) as a primary treatment for brain metastases.
  • To assess the role of GKS salvage treatment for new distant lesions.
  • To determine the impact of GKS on neurologic death and quality of life.

Main Methods:

  • Retrospective review of 2645 patients treated with GKS for brain metastases.
  • Standardized treatment protocol involving GKS without upfront WBRT.
  • Regular surveillance with gadolinium-enhanced MRI every 2-3 months.
  • Salvage GKS for newly detected distant lesions.

Main Results:

  • GKS demonstrated effective control of brain metastases.
  • New distant lesions were primarily managed successfully with salvage GKS.
  • The treatment protocol showed potential in preventing neurologic death and maintaining daily activities.

Conclusions:

  • Gamma Knife radiosurgery is a viable primary treatment option for brain metastases, avoiding upfront WBRT.
  • Salvage GKS is an effective strategy for managing new, distant brain metastases.
  • Continuous MRI monitoring and timely salvage interventions are essential for optimal patient outcomes.