A review of stereotactic radiosurgery in the management of brain metastases.

Abstract:

:This review addresses the epidemiology, historical reports, current issues, data and controversies involved in the management of brain metastases. The literature regarding surgery, whole brain radiation therapy, stereotactic radiosurgery or some combination of those treatments is discussed as well as issues of cost-effectiveness. Ongoing prospective randomized trials will further elucidate the optimal management for patients with brain metastases. Until those data are available, clinicians are encouraged to apply the existing data reviewed here in conjunction with best clinical judgment. A brief clinical guide is as follows. Patients with a solitary metastasis in an operable location and symptomatic mass effect should undergo surgery. Patients with poor performance status (KPS < 70) or more than three brain metastases should receive WBRT alone. Patients with 1-3 brain metastases and KPS >or= 70, should receive WBRT + SRS. If the patient refuses WBRT or needs salvage after WBRT, then SRS alone is appropriate. Clinicians should not be too dogmatic and should always apply the best clinical judgment.

authors

Sperduto PW

doi

10.1177/153303460300200205

keywords:

subject

Has Abstract

pub_date

2003-04-01 00:00:00

pages

105-10

issue

2

eissn

1533-0346

issn

1533-0338

pii

d=3015&c=4107&p=11648&do=detail

journal_volume

2

pub_type

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