Stereotactic Radiosurgery in the Treatment of Brain Metastases from Colorectal Cancer: Should Patients be Treated with Up-front Whole-brain Radiotherapy?

Kahn, E; Mondschein, J.; Chakravarthy, A.B.; Cmelak, Anthony J.; Berlin, Jordan; Thompson, Reid C.; Weaver, Kyle D.; Li, M.; Xia, Fan

doi:10.1016/j.ijrobp.2010.07.653

Cited by 1 publication

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“…If surgery was not possible, a procedure for local control such as stereotactic radiosurgery or gamma-knife radiosurgery provided better OS in patients with 1–3 metastases [ 86 , 87 , 88 , 89 , 90 ]. With these procedures, local control of BM was possible in up to 95% of patients [ 90 ].…”

Section: Resultsmentioning

confidence: 99%

“…If neurosurgical resection is not possible, the number of BM is essential for defining the best treatment option. In patients with 1–3 BM, radiosurgery or gamma-knife radiosurgery is recommended, whereas patients with more than three BM should receive whole-brain radiation [ 86 , 87 , 88 , 89 , 90 ]. Our recommended treatment algorithm is shown in Figure 10 .…”

Section: Discussionmentioning

confidence: 99%

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Brain Metastases from Colorectal Cancer: A Systematic Review of the Literature and Meta-Analysis to Establish a Guideline for Daily Treatment

Müller

Köhler

Hendricks

et al. 2021

Cancers

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Colorectal cancer (CRC) is the third most common malignancy worldwide. Most patients with metastatic CRC develop liver or lung metastases, while a minority suffer from brain metastases. There is little information available regarding the presentation, treatment, and overall survival of brain metastases (BM) from CRC. This systematic review and meta-analysis includes data collected from three major databases (PubMed, Cochrane, and Embase) based on the key words “brain”, “metastas*”, “tumor”, “colorectal”, “cancer”, and “malignancy”. In total, 1318 articles were identified in the search and 86 studies matched the inclusion criteria. The incidence of BM varied between 0.1% and 11.5%. Most patients developed metastases at other sites prior to developing BM. Lung metastases and KRAS mutations were described as risk factors for additional BM. Patients with BM suffered from various symptoms, but up to 96.8% of BM patients were asymptomatic at the time of BM diagnosis. Median survival time ranged from 2 to 9.6 months, and overall survival (OS) increased up to 41.1 months in patients on a multimodal therapy regimen. Several factors including age, blood levels of carcinoembryonic antigen (CEA), multiple metastases sites, number of brain lesions, and presence of the KRAS mutation were predictors of OS. For BM diagnosis, MRI was considered to be state of the art. Treatment consisted of a combination of surgery, radiation, or systemic treatment.

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