title: Does the surgical resection of a brain metastasis alter the planning and subsequent local control achieved with radiosurgery prescribed for recurrence at the operated site?
abstract: Multiple treatments may be used in the management of patients with brain metastases including surgical resection or radiosurgery. In order to determine whether initial surgical resection in any way prejudices the subsequent efficacy of radiosurgery for recurrence at the operated site, a retrospective review of patients undergoing radiosurgery at the time of relapse was undertaken. All patients had previously received whole brain irradiation as part of initial management. A comparison of radiosurgical planning technique was made for recurrent brain metastases occurring at sites of a previous surgical resection versus unresected recurrences. Although recurrences of tumour at a resected site were more likely to be treated radiosurgically using larger and multiple collimators, there was no significant difference in subsequent local control. Assuming that the recurrence of a brain metastasis at a previously resected site is considered treatable radiosurgically, subsequent local control is no different from that achieved in previously unresected recurrences.
authors.affiliation: Division of Radiation Oncology, Odette Cancer Centre & Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. julie.stanford@sunnybrook.ca
authors.forename: Julie
authors.initials: J
authors.lastname: Stanford
authors.forename: Sandra
authors.initials: S
authors.lastname: Gardner
authors.forename: Michael L
authors.initials: ML
authors.lastname: Schwartz
authors.forename: Phillip
authors.initials: P
authors.lastname: Davey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D002423:Cause of Death; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery*; D010347:Patient Care Planning; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome