Brain metastases: radiosurgery

Area of Science:

• Neurosurgery
• Radiation Oncology
• Oncology

Background:

• Brain metastases significantly impact patient outcomes and quality of life.
• Traditional treatments for brain metastases include surgery and whole-brain radiation therapy, which can have significant toxicities.
• Stereotactic radiosurgery (SRS) has emerged as a key modality in managing intracranial malignancies.

Purpose of the Study:

• To review the role and efficacy of stereotactic radiosurgery in the management of brain metastases.
• To highlight the benefits of SRS, including its precision, low toxicity, and effectiveness in cases with multiple metastases.
• To discuss the integration of SRS with modern systemic therapies and advanced imaging for comprehensive cancer care.

Main Methods:

• Review of randomized controlled trials and prospective studies evaluating SRS for brain metastases.
• Analysis of treatment outcomes, including survival rates and local tumor control.
• Assessment of SRS in conjunction with systemic therapies (chemotherapy, targeted therapy, immunotherapy).

Main Results:

• SRS demonstrates a survival advantage and high local control rates for brain metastases, even with up to 10 lesions.
• SRS is a minimally invasive alternative to surgical resection with reduced toxicity to surrounding brain tissue.
• Concurrent administration of SRS with systemic therapies may yield additive or synergistic effects, accelerating treatment.

Conclusions:

• Stereotactic radiosurgery is a cornerstone in the modern management of brain metastases.
• Routine MRI surveillance in high-risk cancer patients facilitates early detection and prompt SRS treatment, preventing neurological deficits.
• The combination of SRS with advanced systemic therapies represents a significant advancement in treating both intracranial and extracranial metastatic disease.