Tumor bed radiosurgery following resection of brain metastases: a review.
There is a growing interest in adjuvant radiosurgery following resection of hematogenous brain metastases. We have identified 12 series reporting on a total of 480 patients treated to a tumor bed following microsurgery. These cases fall into 3 paradigms: adjuvant radiosurgery as an alternative to whole-brain radiotherapy (WBRT), radiosurgery as an intensification of adjuvant WBRT and adjuvant radiosurgery for patients having failed prior WBRT. For these paradigms the reported crude local control rates are 79%, 92% and 95%, respectively. The procedure appears well tolerate with approximately a 5% risk of late radiation necrosis. Prospective data is lagging behind clinical practice and plans for prospective trials are discussed.
Department of Oncology, Division of Radiation Oncology, McGill University, 1650 Cedar Avenue, Montreal, QC H3G 1A4, Canada. david.roberge@muhc.mcgill.ca
David
D
Roberge
Luis
L
Souhami
D001932:Brain Neoplasms / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery*; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D016634:Radiosurgery / Q000379:methods*; D018714:Radiotherapy, Adjuvant; D012008:Recurrence