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Linac radiosurgery in brain metastases

J Voges1, H Treuer, J Erdmann

  • 1Department of Stereotactic and Functional Neurosurgery, University of Cologne, Federal Republic of Germany.

Acta Neurochirurgica. Supplement
|January 1, 1994
PubMed
Summary

Linac-based radiosurgery (RS) effectively treats brain metastases. This study shows tumor shrinkage and growth cessation in most patients receiving RS for 1-3 brain metastases.

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Area of Science:

  • Neurosurgery
  • Radiation Oncology
  • Medical Physics

Background:

  • Brain metastases are typically well-defined, spherical lesions suitable for radiosurgery.
  • Previous pilot studies indicated the efficacy of Linac-based radiosurgery (RS) for solitary, low-radiosensitivity brain metastases.

Purpose of the Study:

  • To evaluate the effectiveness of Linac-based radiosurgery (RS) in treating patients with 1-3 brain metastases.
  • To assess tumor response, progression, and clinical outcomes following RS.

Main Methods:

  • A series of 46 patients with 1-3 brain metastases were treated with Linac-RS between 1990 and 1993.
  • Radiation doses ranged from 10 to 25 Gy, adjusted for tumor size, number, location, and prior whole-brain radiotherapy (WBRT).
  • Follow-up included clinical status and imaging (CT/MR) at 6-12 week intervals.

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Main Results:

  • Of 34 patients with adequate follow-up (>12 weeks), 11 showed growth cessation and 18 showed tumor shrinkage.
  • Clinical improvement and reduced surrounding edema were observed in a significant number of patients.
  • Tumor progression occurred in 5/34 patients, and 14/46 patients died from generalized disease progression.

Conclusions:

  • Linac-based radiosurgery is an effective treatment for 1-3 brain metastases, leading to tumor control and clinical amelioration in most patients.
  • RS can be considered a valuable therapeutic option for selected patients with limited brain metastases.