Gamma Knife surgery for metastatic brainstem tumors

Abstract

Compared with allowing a metastatic brainstem lesion to take its natural course, GKS prolongs survival. The risks associated with such treatment are low. The severity of systemic diseases largely determines the prognosis of metastases to the brainstem.

Cyberknife® Radiosurgery and Fractionated Stereotactic Radiotherapy For Brainstem or Adjacent-to-Brainstem Metastases

“…16,17 All of these studies have shown that SRS is a safe, reliable, and efficient treatment method for brainstem metastases. [3][4][5][6][13][14][15][16][17] This study differs from others in reporting treatment results of not only metastases in the brainstem but also those that are adjacent to brainstem (≤5 mm) and using CyberKnife as an FSRT/ SRS system. The CyberKnife SRT system has certain improved features of utility compared to the Gamma Knife radiosurgery system.…”

“…In the current literature, most of the studies have used Gamma Knife for the treatment of brainstem metastases using stereotactic radiosurgery. 3,5,6,[13][14][15] In addition, there are other studies in which linac-based systems were used as a means of SRS. 16,17 All of these studies have shown that SRS is a safe, reliable, and efficient treatment method for brainstem metastases.…”

“…Dose range for different SRS series using Gamma Knife or a linac for the treatment of brainstem metastases were between 1,300 and 2,000 cGy, in one fraction. [3][4][5][6]13,16 In the final report of RTOG protocol 90-05, patients with cerebral or cerebellar solitary non-brainstem tumors with a maximum diameter of 40 mm were evaluated. Of 156 patients, 36% had recurrent primary brain tumors (prior median dose 60 Gy) and 64% had recurrent brain metastases (prior median dose 30 Gy).…”

“…[3][4][5][6] Therefore, the most beneficial treatment of brainstem metastases with surgery, radiosurgery, WBRT, FSRT, or combinations of these is controversial. A recent study concluded that fractionated stereotactic radiotherapy (FSRT) was a more effective and safe treatment compared to single dose radiosurgery.…”

“…[3][4][5][6] Successful surgical resection is difficult and may lead to significant neurologic sequelae. Therefore, treatment options for brainstem metastases are whole-brain radiotherapy (WBRT) or stereotactic radiotherapy or radiosurgery.…”