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A Novel Approach for Stereotactic Radiosurgery of Multiple Brain Metastasis in a Patient With Poor Performance
Arad Iranmehr1,2, Shakiba Sheikholeslami3, Nooshin Banaee4
1Neurosurgery Department, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran, tums.ac.ir.
Background:
Brain metastases are the most common malignant intracranial tumors in adults. The management of patients with poor performance status and multiple brain metastases remains controversial, with guidelines generally recommending palliative care in such cases. Stereotactic radiosurgery has been debated for this group of patients, particularly those with multiple lesions.
Case Presentation:
We present a case of an Iranian patient with metastatic non-small cell lung cancer (NSCLC) who had previously undergone whole-brain irradiation (WBRT). The patient was referred due to the progression of multiple brain lesions. In response, we administered two separate courses of fractionated stereotactic radiation therapy (FSRT) to treat these brain masses. The patient's neurological symptoms showed significant improvement following the treatment.
Conclusions:
This case suggests that stereotactic radiation therapy can be considered for patients with poor performance status, regardless of the number of brain metastases. It may stabilize or improve neurological deficits and enhance the patient's quality of life, even if its effect on overall survival is uncertain. Additionally, treating the lesions in two separate courses may reduce treatment time and facilitate better repair of normal brain tissue.
