Treatment of high numbers of brain metastases with Gamma Knife radiosurgery: a review.

Abstract:

:Effectiveness of stereotactic radiosurgery (SRS) has been shown in patients with one to four brain metastases. Work has been done to evaluate the role of SRS alone treatment without whole-brain radiation therapy in patients with more than four metastases. A recent multiinstitutional JLGK 0901 prospective study revealed the class-2 evidence that SRS without whole-brain radiation therapy is an effective treatment for patients up to 10 metastatic lesions. Several retrospective studies exist to show the efficacy and safety of SRS for patients with even more than 10 lesions. However, patient selection is very critical for SRS alone treatment. The PubMed database was searched using combinations of search terms and synonyms for multiple brain metastases, Gamma Knife and SRS published between January 1, 2005 and January 1, 2015 in order to address the effectiveness of Gamma Knife for patients with multiple brain metastases. Good performance status, controlled primary disease, total treated tumor volume of 15 cm(3) or less have been found to be significant predictors for survival among patients with two or more brain lesions. The data suggest that SRS can be used and whole brain radiation therapy can be withheld in selected patients with multiple lesions to avoid acute or chronic adverse effects, especially neurocognitive decline, without causing survival disadvantage. In this review, we assessed the evidence for SRS treatment of patients with multiple brain metastases.

journal_name

Acta Neurochir (Wien)

journal_title

Acta neurochirurgica

authors

Hatiboglu MA,Tuzgen S,Akdur K,Chang EL

doi

10.1007/s00701-016-2707-6

subject

Has Abstract

pub_date

2016-04-01 00:00:00

pages

625-634

issue

4

eissn

0001-6268

issn

0942-0940

pii

10.1007/s00701-016-2707-6

journal_volume

158

pub_type

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