Radiosurgery to the Surgical Cavity as Adjuvant Therapy for Resected Brain Metastasis

Abstract

Radiosurgery to the surgical cavity without WBRT achieved excellent local control of resected brain metastasis. Close imaging follow-up allows early intervention for any new metastasis.

Stereotactic Radiosurgery to the Resection Cavity for Brain Metastases: Prognostic Factors and Outcomes

“…This agrees favorably with other institutions which have reported on local controls in the range of 70-94%. 14,15,16 Despite the efficacy of this modality in treating the resection cavity, we experienced a single melanoma case that grew immediately after SRS without any interval of response. This demonstrates that at times the biology plays a predominant role in influencing outcomes.…”

A new paradigm in treatment of brain metastases

“…SRS has been used in a single or limited number of fractions (≤ 5) to treat the surgical resection cavity. Retrospective series suggest local control of approximately 75-80% at 1 year following SRS to the resection cavity [15,121]. In retrospective analysis, there does not appear to be a difference in overall survival or local control between postoperative WBRT or cavity SRS, although predictably, cavity SRS led to a higher rate of distant brain recurrences [122].…”

Sarcomatoid carcinoma of the lung with brain metastases

“…( 1 - 4 ) The treatment is essentially performed with surgical resection, chemotherapy and radiotherapy being used as adjuvant therapy or in cases of poor surgical conditions, since there seems to be little benefit. ( 1 - 4 , 6 , 7 ) The five-year survival for patients with sarcomatoid carcinoma is approximately 20% (compared with 50% for those with non-small cell lung cancer), and the median duration of survival is three months. ( 1 , 2 , 5 , 7 )…”

“…( 1 - 4 ) O tratamento consiste essencialmente em resseção cirúrgica; a quimioterapia e a radioterapia são usadas como terapia adjuvante ou em caso de más condições cirúrgicas, pois o benefício é aparentemente pequeno. ( 1 - 4 , 6 , 7 ) A taxa de sobrevida em cinco anos para pacientes com carcinoma sarcomatoide é de aproximadamente 20% (contra 50% para aqueles com câncer pulmonar de células não pequenas), e a mediana da sobrevida é de três meses. ( 1 , 2 , 5 , 7 )…”