Repeat Stereotactic Radiosurgery for Recurred Metastatic Brain Tumors

Area of Science:

• Neurosurgery
• Radiation Oncology
• Oncology

Background:

• Metastatic brain tumors often recur after initial treatment.
• Repeat stereotactic radiosurgery (SRS) is an option for local recurrence.
• Understanding outcomes of repeat SRS is crucial for patient management.

Purpose of the Study:

• To investigate the tumor control and survival outcomes of repeat SRS for brain metastases with local recurrence after prior SRS.
• To identify prognostic factors associated with tumor control after repeat SRS.

Main Methods:

• Retrospective analysis of 114 patients with 176 locally recurring metastatic brain tumors treated with repeat SRS.
• Data collected included patient demographics, primary cancer type, tumor volume, and radiation dose.
• Follow-up included clinical and MRI data to assess tumor control and survival.

Main Results:

• Tumor control was achieved in 53.5% of 108 evaluable tumors after repeat SRS.
• Median progression-free survival (PFS) was 246 days; median overall survival (OS) was 229 days.
• Higher radiation dose (≥16 Gy) and smaller tumor volume (<4 mL or <10 mL) were significantly associated with better tumor control.

Conclusions:

• Repeat SRS provides a viable option for locally recurrent brain metastases, though tumor control rates are lower than primary SRS.
• Tumor volume and radiation dose are critical factors influencing the success of repeat SRS.
• Findings align with principles of primary SRS, emphasizing dose and volume considerations.