title: Stereotactic radiosurgery to the resection cavity of brain metastases: a retrospective analysis and literature review.
abstract: OBJECTIVE
  The aim of this study was to analyze results of stereotactic radiosurgery (SRS) as adjuvant therapy for resected brain metastases.
  
  
  METHODS
  Medical records of patients treated at a single institution with SRS to the postoperative cavity of brain metastases were retrospectively reviewed. Patients who completed the prescribed SRS regimen following gross-total resection and had no previous whole brain radiotherapy were included in the study. Kaplan-Meier analyses were used to estimate local (LC) and intracranial control (IC), and overall survival (OS) rates.
  
  
  RESULTS
  Between April 2005 and July 2010, 77 patients (median age 63 years) with 89 metastases met the inclusion criteria. The median prescription dose was 18 Gy (12-27 Gy) delivered in 1-3 fractions for a median target volume of 7.6 cm(3) (0.5-59 cm(3)). The 6-month, 1-year, and 2-year LC rates were 76.1, 76.1, and 74.3%, respectively. The 6-month, 1-year, and 2-year IC rates were 75.2, 54, and 43.6%, respectively. With a median follow-up of 13.8 months, the median OS was 14.5 months (1.9-51.4 months) after SRS. The overall 6-month, 1-year, and 2-year OS rates were 91, 62.5, and 43.6%, respectively. Complications included 2 patients with radiation necrosis.
  
  
  CONCLUSIONS
  Adjuvant radiosurgery to the tumor cavity of resected brain metastases is well-tolerated and achieves LC in the majority of patients.
authors: Department of Radiation Oncology, University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
authors: Jean-Claude M
authors: JC
authors: Rwigema
authors: Rodney E
authors: RE
authors: Wegner
authors: Arlan H
authors: AH
authors: Mintz
authors: Anthony J
authors: AJ
authors: Paravati
authors: Steven A
authors: SA
authors: Burton
authors: Cihat
authors: C
authors: Ozhasoglu
authors: Dwight E
authors: DE
authors: Heron
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000556:secondary / Q000601:surgery*; D016371:Cranial Irradiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery; D012189:Retrospective Studies; D016896:Treatment Outcome