Stereotactic radiosurgery for a single brain metastasis: factors impacting control

Area of Science:

• Neurosurgery
• Radiation Oncology
• Oncology

Background:

• Stereotactic radiosurgery (SRS) is a key treatment for brain metastases.
• Its precise role, especially for single metastases, requires further clarification.
• Limited outcome data exists for patients with a single brain metastasis at presentation.

Purpose of the Study:

• To assess treatment outcomes in patients with a single brain metastasis.
• To identify factors influencing local control (LC) after SRS.
• To evaluate the efficacy of SRS in this specific patient subgroup.

Main Methods:

• Retrospective analysis of patients treated with SRS for a single brain metastasis.
• Data collection included patient demographics, treatment details, and outcomes.
• Univariate analyses were conducted to determine the impact of various factors on LC and distant intracranial control (DIC).

Main Results:

• 141 patients received SRS for single brain metastases between 1998 and 2011.
• Addition of whole brain radiotherapy (WBRT) or surgery did not significantly improve LC or DIC.
• Larger tumors, doses under 20Gy, and tight conformity ratios were associated with decreased LC (p=0.02).
• 73% of patients achieved long-term freedom from requiring WBRT.

Conclusions:

• SRS alone provides acceptable intracranial outcomes for patients with single brain metastases.
• Further research is needed to fully understand factors affecting local control.
• Optimizing SRS parameters may improve outcomes in this patient group.