Stereotactic radiosurgery with and without whole-brain radiotherapy for newly diagnosed brain metastases.
Brain metastases develop in 20-40% of cancer patients and can cause significant morbidity. In selected patients with one to three lesions, stereotactic radiosurgery may be used to improve local control. However, it is unclear whether whole-brain radiotherapy is necessary for all patients who are candidates for stereotactic radiosurgery. While whole-brain radiotherapy may improve the locoregional control of brain metastases, it may cause long-term side effects and may not improve overall survival in some patients. Its benefits should be evaluated in the context of risks of neurocognitive deterioration, either from whole-brain radiotherapy or from uncontrolled brain metastases, and the possible need for salvage treatments with the omission of initial whole-brain radiotherapy. For certain radioresistant brain metastases, the benefit of whole-brain radiotherapy to patients who have stereotactic radiosurgery is uncertain.
Lo
Simon S
SS
Department of Radiation Oncology, Indiana Lions Gamma Knife Center, Indiana University Medical Center, 535 Barnhill Drive, RT 041, Indianapolis, IN 46202, USA. slo@iupui.edu
Chang
Eric L
EL
Suh
John H
JH
D001932:Brain Neoplasms / Q000175:diagnosis / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology; D016634:Radiosurgery / Q000379:methods*