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Stereotactic radiosurgery for brain metastases.

Stylianos Pikis1, Maria Protopapa1, Georgios Mantziaris2

  • 1Radiation Oncology and Stereotactic Radiosurgery Center, Mediterraneo Hospital, Athens, Greece.

Advances in Cancer Research
|June 15, 2025
PubMed
Summary

Stereotactic radiosurgery (SRS) advances offer improved outcomes for brain metastases. New techniques like frameless SRS and neoadjuvant SRS show promise, requiring further clinical evaluation for optimal cancer patient care.

Keywords:
Brain metastasesHypo-fractionationRadiosurgeryRe-irradiationSRS

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Area of Science:

  • Neuro-oncology
  • Radiation Oncology
  • Medical Physics

Background:

  • Brain metastases are common intracranial malignancies, impacting up to 50% of cancer patients.
  • Current therapies improve survival, but opportunities exist to further enhance patient outcomes.
  • Stereotactic radiosurgery (SRS) is a standard treatment for limited brain metastases, often used adjunctively.

Purpose of the Study:

  • To review established and emerging indications for SRS in treating brain metastases.
  • To discuss advancements in SRS technology and techniques.
  • To explore the integration of SRS with systemic therapies.

Main Methods:

  • Review of current literature on SRS for brain metastases.
  • Discussion of established SRS protocols and novel techniques.
  • Analysis of combined treatment approaches including systemic therapies.

Main Results:

  • SRS is a precise, high-dose radiation technique for intracranial tumors.
  • Frameless SRS expands treatment possibilities for larger or critically located lesions.
  • Neoadjuvant SRS may reduce leptomeningeal dissemination risk.
  • Concurrent SRS with systemic therapies shows promising local control and safety.

Conclusions:

  • Continued evaluation of novel SRS techniques through clinical trials is essential.
  • Optimizing the combination of SRS, precision medicine, and immunotherapy is crucial for improved patient outcomes.
  • SRS remains a vital tool in the multidisciplinary management of brain metastases.