Linear Accelerator Radiosurgery in the Treatment of Brain Metastases

Neurosurgery ◽  
2004 ◽  
Vol 55 (5) ◽  
pp. 1076-1085 ◽  
Author(s):  
Arthur J. Ulm ◽  
William A. Friedman ◽  
Frank J. Bova ◽  
Patrick Bradshaw ◽  
Robert J. Amdur ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Brain Metastases ◽  
Local Control ◽  
Linear Accelerator ◽  
Whole Brain Radiation Therapy ◽  
Tumor Type ◽  
Whole Brain ◽  
Regional Control ◽  
Whole Brain Radiation ◽  
Brain Radiation

Abstract OBJECTIVE: To review a 12-year experience treating metastatic brain disease with linear accelerator-based stereotactic radiosurgery (SRS). METHODS: We performed a retrospective analysis of all patients treated between 1989 and 2001 with linear accelerator radiosurgery for brain metastases. Patients were followed up both clinically and with imaging studies to document local control, regional control, and survival. Demographic data, dosing parameters, number of lesions, histology, history of whole-brain radiation therapy, and other factors were obtained prospectively. Cox proportional-hazards regression with multivariate and univariate analysis was performed with Stata 8.0 software. RESULTS: A total of 383 patients received SRS for brain metastases during the study interval. Median survival was 9 months. Patients with tumor-type melanoma or multiple metastatic lesions had decreased survival. Actuarial 1-year local control was 75%. Differences in regional control rates were not statistically significant between patients treated with SRS and whole-brain radiation therapy versus SRS alone. CONCLUSION: Radiosurgery is an effective and safe method for treating selected patients with brain metastases.

Focal radiation therapy for limited brain metastases is associated with high rates of local control and low subsequent whole brain radiation therapy

2019 ◽  
Vol 89 (4) ◽  
pp. 418-422 ◽  
Author(s):  
Michelle Or ◽  
Dasantha Jayamanne ◽  
Lesley Guo ◽  
Mark Stevens ◽  
Jonathon Parkinson ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Brain Metastases ◽  
Local Control ◽  
Whole Brain Radiation Therapy ◽  
Whole Brain ◽  
Whole Brain Radiation ◽  
Brain Radiation

Incidence, timing, and treatment of new brain metastases after Gamma Knife surgery for limited brain disease: the case for reducing the use of whole-brain radiation therapy

2011 ◽  
Vol 115 (1) ◽  
pp. 37-48 ◽  
Author(s):  
Stephen Rush ◽  
Robert E. Elliott ◽  
Amr Morsi ◽  
Nisha Mehta ◽  
Jeri Spriet ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Brain Metastases ◽  
Gamma Knife ◽  
Gamma Knife Surgery ◽  
Whole Brain Radiation Therapy ◽  
Leptomeningeal Disease ◽  
Whole Brain ◽  
Whole Brain Radiation ◽  
Brain Radiation

Object In this paper, the authors' goal was to analyze the incidence, timing, and treatment of new metastases following initial treatment with 20-Gy Gamma Knife surgery (GKS) alone in patients with limited brain metastases without whole-brain radiation therapy (WBRT). Methods A retrospective analysis of 114 consecutive adults (75 women and 34 men; median age 61 years) with KPS scores of 60 or higher who received GKS for 1–3 brain metastases ≤ 2 cm was performed (median lesion volume 0.35 cm3). Five patients lacking follow-up data were excluded from analysis. After treatment, patients underwent MR imaging at 6 weeks and every 3 months thereafter. New metastases were preferentially treated with additional GKS. Indications for WBRT included development of numerous metastases, leptomeningeal disease, or diffuse surgical-site recurrence. Results The median overall survival from GKS was 13.8 months. Excluding the 3 patients who died before follow-up imaging, 12 patients (11.3%) experienced local failure at a median of 7.4 months. Fifty-three patients (50%) developed new metastases at a median of 5 months. Six (7%) of 86 instances of new lesions were symptomatic. Most patients (67%) with distant failures were successfully treated using salvage GKS alone. Whole-brain radiotherapy was indicated in 20 patients (18.3%). Thirteen patients (11.9%) died of neurological disease. Conclusions For patients with limited brain metastases and functional independence, 20-Gy GKS provides excellent disease control and high-functioning survival with minimal morbidity. New metastases developed in almost 50% of patients, but additional GKS was extremely effective in controlling disease. Using our algorithm, fewer than 20% of patients required WBRT, and only 12% died of progressive intracranial disease.

Simultaneously Integrated Boost to Multiple Brain Metastases during Whole Brain Radiation Therapy-Hippocampal Avoidance

Radiosurgery ◽  
2010 ◽  
pp. 247-257 ◽  
Author(s):  
Alonso N. Gutiérrez ◽  
Wolfgang A. Tomé ◽  
Amol Ghia ◽  
Sayana Thomas ◽  
George Cannon ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Brain Metastases ◽  
Whole Brain Radiation Therapy ◽  
Whole Brain ◽  
Multiple Brain Metastases ◽  
Whole Brain Radiation ◽  
Hippocampal Avoidance ◽  
Integrated Boost ◽  
Brain Radiation
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