Stereotactic radiosurgical treatment of brain metastases.
In a series of 33 patients with reasonably controlled primary cancers, stereotactic radiosurgery was used to treat 52 brain metastases. After a mean radiological follow-up time of 5.5 months, six lesions (12%) had stabilized in size, 26 (50%) were significantly reduced, and 15 (29%) had disappeared. One large melanoma metastasis progressed relentlessly despite treatment. Five lesions (9%) had decreased in size slightly before enlarging. In two of these lesions, biopsy revealed only necrosis. In almost all cases, treatment was associated with decreased peritumoral edema. However, a group of patients with large metastases and extensive prior brain irradiation has been identified in whom prolonged symptomatic cerebral edema poses a problem. It is concluded that radiosurgery is a viable alternative to surgical resection for some cases of brain metastasis.
Adler
J R
JR
Department of Neurosurgery, Stanford University Medical Center, California.
Cox
R S
RS
Kaplan
I
I
Martin
D P
DP
D000328:Adult; D000368:Aged; D001929:Brain Edema / Q000209:etiology; D001932:Brain Neoplasms / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery / Q000009:adverse effects; D011878:Radiotherapy / Q000009:adverse effects