A Comprehensive Review of the Role of Radiosurgery in Patients with Intracranial Metastases

Radiosurgery for brain metastases at the Royal Adelaide Hospital: Are we treating the right patients?

“…The overall median survival for our 16 patients was 10.1 months. This is very similar to recent multi‐institutional reviews by Boyd and Mehta who found for 1250 patients a series average survival of 9.6 months (range 5−15 months), 9 and by Sanghavi et al . who obtained an overall median survival of 10.7 months for 502 patients 7 .…”

“…Radiosurgery is not constrained by number of metastases whereas S is usually restricted to one or two (occasionally three) lesions. However, in situations where there are no relative contraindications to either option, there is as yet no answer to the above question as no randomized trials have been completed at the time of writing that we are aware of, although retrospective data suggest that they produce comparable survival 9 but that RS is more cost‐effective 10,11 . It is hoped that solitary brain meta­stases studies currently underway at the MD Anderson Cancer Centre (S versus RS both without adjuvant WBRT; Lang pers.…”

Radiosurgery at the Royal Adelaide Hospital: The first 41/2years’ clinical experience

“…This literature is well summarized by Boyd and Mehta. 17 In their review, actuarial 2‐year local control rates approximate 65% and median survivals range from 5 to 15 months (average 9.6 months). Non‐randomized data suggest that RS has similar efficacy but superior cost‐effectiveness to resection, and improved survival compared with WBRT alone, but there is probably no survival benefit from the addition of WBRT to RS.…”

“…Seizures Treatment‐induced seizures are reported in approximately 5% of patients, typically those with cortical lesions and a prior seizure history. 17 Prophylactic anticonvulsant premedication is suggested for such patients, although it is not always effective (as in our single case).…”

Gamma knife radiosurgery for multiple brain metastases from lung cancer

“…13 In a comprehensive review by Boyd and Mehta, GKS was generally recognized as the most effective treatment modality for patients with brain metastases, whether they were radiosensitive or radioresistant, single or multiple. 14 Amendola et al used GKS to treat 72 patients with multiple brain metastases, and reported that GKS was a cost-effective palliative method while maintaining a reasonable QoL. 10 Yang et al reported that as many as 25 lesions could be safely treated without producing acute side effects.…”