Related Experiment Video
Updated: Oct 18, 2025
Stereotactic Radiosurgery for Gynecologic Cancer
Published on: April 17, 2012
Stereotactic radiosurgery for prostate cancer cerebral metastases: an international multicenter study
Stylianos Pikis1, Adomas Bunevicius1, Cheng-Chia Lee2
11Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia.
Objective:
As novel therapies improve survival for men with prostate cancer, intracranial metastatic disease has become more common. The purpose of this multicenter study was to evaluate the safety and efficacy of stereotactic radiosurgery (SRS) in the management of intracranial prostate cancer metastases.
Methods:
Demographic data, primary tumor characteristics, SRS treatment parameters, and clinical and imaging follow-up data of patients from nine institutions treated with SRS from July 2005 to June 2020 for cerebral metastases from prostate carcinoma were collected and analyzed.
Results:
Forty-six patients were treated in 51 SRS procedures for 120 prostate cancer intracranial metastases. At SRS, the mean patient age was 68.04 ± 9.05 years, the mean time interval from prostate cancer diagnosis to SRS was 4.82 ± 4.89 years, and extracranial dissemination was noted in 34 (73.9%) patients. The median patient Karnofsky Performance Scale (KPS) score at SRS was 80, and neurological symptoms attributed to intracranial involvement were present prior to 39 (76%) SRS procedures. Single-fraction SRS was used in 49 procedures. Stereotactic radiotherapy using 6 Gy in five sessions was utilized in 2 procedures. The median margin dose was 18 (range 6-28) Gy, and the median tumor volume was 2.45 (range 0.04-45) ml. At a median radiological follow-up of 6 (range 0-156) months, local progression was seen with 14 lesions. The median survival following SRS was 15.18 months, and the 1-year overall intracranial progression-free survival was 44%. The KPS score at SRS was noted to be associated with improved overall (p = 0.02) and progression-free survival (p = 0.03). Age ≥ 65 years at SRS was associated with decreased overall survival (p = 0.04). There were no serious grade 3-5 toxicities noted.
Conclusions:
SRS appears to be a safe, well-tolerated, and effective management option for patients with prostate cancer intracranial metastases.
Insights
Stereotactic radiosurgery (SRS) is a safe and effective treatment for prostate cancer brain metastases. It offers good local control and survival rates, with KPS score and age impacting outcomes.
Area of Science:
- Neuro-oncology
- Radiation Oncology
- Urologic Oncology
Background:
- Improving survival in prostate cancer has increased intracranial metastases.
- Stereotactic radiosurgery (SRS) is a key treatment modality for brain metastases.
Purpose of the Study:
- To evaluate the safety and efficacy of SRS for intracranial prostate cancer metastases.
- To analyze patient and treatment factors influencing outcomes.
Main Methods:
- Multicenter study of 46 patients with 120 intracranial prostate cancer metastases.
- Data collected on demographics, tumor characteristics, SRS parameters, and follow-up.
- Analysis of local progression, survival, and toxicity.
Main Results:
- Median survival post-SRS was 15.18 months; 1-year intracranial progression-free survival was 44%.
- Karnofsky Performance Scale (KPS) score at SRS correlated with improved survival.
- Age ≥ 65 years was associated with decreased overall survival; no grade 3-5 toxicities observed.
Conclusions:
- SRS is a safe, well-tolerated, and effective option for prostate cancer brain metastases.
- Patient factors like KPS and age influence treatment outcomes.
