[The use of radiosurgery in the treatment of patients with single brain metastasis].

Abstract

Brain metastases occur in approximately 20% of all cancer patients. Stereotactic radiosurgery alone and in combination with surgical resection is one of the approaches to treating patients with brain metastases.

Objective: To evaluate the effectiveness of stereotactic radiosurgery regarding local control, overall survival and complications; to compare stereotactic radiosurgery alone and preoperative stereotactic radiotherapy.

Material and methods: A retrospective study included 85 patients with single brain metastasis. The first group comprised 45 patients who underwent stereotactic radiosurgery, while the second group included 40 patients who underwent preoperative stereotactic radiotherapy and subsequent surgical treatment. Mean age was 59 and 56 years (p=0.2), radiation volume - 4.4 and 15.9 cm³, respectively (p<0.05).

Results: Local growth control after preoperative stereotactic radiotherapy followed by resection was 100%, 97.5%, and 87.5% after 3, 6, and 12 months, respectively. After stereotactic radiotherapy alone, these values were 100%, 95.6% and 88.9%, respectively (p=0.4). One-year survival was 87.5% after preoperative radiotherapy and 64.4% after stereotactic radiosurgery alone (p<0.05). Among 85 patients, 16 (18.8%) ones had long-term surgical and post-radiation complications.

Conclusion: Stereotactic radiotherapy alone is effective. However, there are limitations in tumor size (up to 2.5 cm) and volume (9.5 cm³). Preoperative stereotactic radiotherapy followed by surgical resection is advisable for larger tumors (up to 4.5 cm and 18.9 cm³) with high rates of overall survival and local growth control.