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Repeat Stereotactic Radiosurgery for Locally Recurrent Brain Metastases
Paul Koffer1, Jason Chan2, Paul Rava3
1Department of Radiation Oncology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA; Department of Radiation Oncology, Tufts Medical Center, Boston, Massachusetts, USA.
World Neurosurgery
|April 29, 2017
Summary
Repeat stereotactic radiosurgery (SRS) is a feasible option for select patients with recurrent brain metastases. Tumor volume less than 4 cm³ is associated with better local control after repeat SRS.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Stereotactic radiosurgery (SRS) is a common treatment for brain metastases.
- Outcomes of repeat SRS after initial SRS failure are not well-established.
- Retreatment strategies for locally recurrent brain metastases require further investigation.
Purpose of the Study:
- To evaluate the outcomes of repeat stereotactic radiosurgery (SRS) for locally recurrent brain metastases.
- To identify factors influencing local control and radiation necrosis after repeat SRS.
- To assess the feasibility and safety of retreatment with SRS.
Main Methods:
- Retrospective review of patients with brain metastases treated with repeat SRS between 2003 and 2015.
- Analysis of local control, radiation necrosis, and overall survival rates.
- Chi-square testing to assess factors affecting local failure and radiation necrosis.
Main Results:
- Repeat SRS was performed on 24 lesions in 22 patients, with a median follow-up of 8.8 months.
- Actuarial local control rates at 6 and 12 months were 94.1% and 61.1%, respectively.
- Tumor volume >4 cm³ correlated with increased local failure risk (P=0.006); no failures occurred with volumes ≤4 cm³.
Conclusions:
- Repeat SRS is a feasible treatment option for select patients with recurrent brain metastases.
- Tumor volume ≤4 cm³ is a favorable factor for local control after repeat SRS.
- Further research is needed to optimize treatment doses and volumes for repeat SRS.
