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This summary is machine-generated.

Neurosurgical resection followed by stereotactic radiotherapy (SRT) for brain metastases (BMs) shows high local control after total resection. Patients with cerebellar metastases have a higher risk of leptomeningeal disease (LMD), suggesting a need for preventive measures.

Keywords:
brain metastasesmeningeal carcinomatosisneurosurgeryradiosurgery

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Area of Science:

  • Neurosurgery
  • Radiation Oncology
  • Oncology

Background:

  • Neurosurgical resection is standard for large brain metastases (BMs).
  • Postoperative stereotactic radiotherapy (SRT) aims to reduce local recurrence (LR) but may not prevent leptomeningeal disease (LMD).
  • Understanding recurrence patterns is crucial for improving treatment efficacy.

Purpose of the Study:

  • Analyze tumor recurrence patterns after surgery and SRT for BMs.
  • Identify factors influencing local recurrence and leptomeningeal disease.
  • Determine opportunities to enhance treatment outcomes for brain metastases.

Main Methods:

  • Retrospective analysis of 147 patients undergoing resection and SRT for BMs.
  • Calculation of distance between resection cavity and new tumor growth.
  • Cox regression analysis to assess LMD risk factors.

Main Results:

  • Median survival was 14 months; 3-year survival rate was 21%.
  • Local recurrence (LR) occurred in 14% of patients, with higher rates after subtotal resection (36%) vs. total resection (21%).
  • Leptomeningeal disease (LMD) developed in 14% of patients, significantly more common in those with cerebellar metastases (23%) compared to cerebral metastases (11%).

Conclusions:

  • Total resection achieved high local control after SRT for BMs.
  • Radiation field size appears adequate, evidenced by low marginal recurrence rates.
  • Cerebellar metastases are associated with increased LMD risk, highlighting the need for preventive strategies, potentially including preoperative SRT.