Preoperative Radiosurgery in Management of Brain Metastases

Abstract

Brain metastases (BMs), the most frequent intracranial tumors, are diagnosed in approximately 30% of all adult patients over the span of planned treatment against a broad spectrum of solid cancers. The prognosis of patients presenting with BM is bleak with an expected median OS of only 4-7 months. However, some particular patients’ groups may enjoy longer survival durations with effective systemic and local therapies. At present, the feasible alternatives for active management of BMs typically include the whole-brain radiotherapy (WBRT), surgery, definitive SRS, postoperative SRS, systemic chemotherapy, targeted therapies, and their combination variants. Considering the local treatment, the severe neurotoxic effects of WBRT, and the increased risk for radionecrosis and leptomeningeal dissemination after postoperative SRS and together with the ineligibility of certain patients during the postoperative period prompted the energetic quest of alternative treatment strategies for such patients. In this respect, the novel preoperative SRS (PO-SRS) was proposed to provide at least equivalent local control rates with lesser radionecrosis and leptomeningeal dissemination risk. Respecting the scarcity of related literature, the present review aimed to meticulously detail theplausible rationale and accessible evidence for the novel PO-SRS in the management of patients presenting with BMs.

Jurnal Review: Pengobatan Klinis Tumor Otak pada Orang Dewasa

“…Tumor cenderung menyebar luas ke otak terdekat sampai jaringan sumsum tulang belakang, seperti astrositoma anaplastik atau glioblastoma, biasanya tidak dapat disembuhkan dengan operasi bedah (Bolukbasi et al, 2020). Proses pembedahan sering dilakukan terlebih dahulu untuk mengurangi jumlah tumor, kemudian diobati dengan radiasi atau kemoterapi, hal ini membantu pe ngobatan ini berhasil dan bisa memperpanjang hidup pada orang tersebut terutama pasien orang dewasa, bahkan jika semua tumor tidak dapat diangkat (Topkan et al, 2020).…”