The Expanding Role of Radiosurgery for Brain Metastases

O’Beirn, Mark; Benghiat, Helen; Meade, Sara; Heyes, G.; Sawlani, Vijay; Kong, Anthony; Hartley, A.; Sanghera, Paul

doi:10.20944/preprints201807.0455.v1

Cited by 6 publications

(3 citation statements)

References 71 publications

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“…Currently, SRS is an established treatment for patients with <4 BMs. 72 [73][74][75] For large lesions not amenable to single-session treatment, staged SRS has shown promise, 76 whereas preliminary studies of re-treated lesions report promising rates of tumor control and side effects. [77][78][79] Finally, new approaches that use metabolic and functional imaging for treatment planning may provide more precise and safe targeting for recurrent treated tumors and those near functional structures such as the corticospinal tracts.…”

Section: Clinical Radiotherapymentioning

confidence: 99%

Emerging treatment strategies for breast cancer brain metastasis: from translational therapeutics to real-world experience

et al. 2020

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Systemic therapies for primary breast cancer have made great progress over the past two decades. However, oncologists confront an insidious and particularly difficult problem: in those patients with metastatic breast cancer, up to 50% of human epidermal growth factor 2 (HER2)-positive and 25–40% of triple-negative subtypes, brain metastases (BM) kill most of them. Fortunately, standard- of-care treatments for BM have improved rapidly, with a decline in whole brain radiation therapy and use of fractionated stereotactic radiosurgery as well as targeted therapies and immunotherapies. Meanwhile, advances in fundamental understanding of the basic biological processes of breast cancer BM (BCBM) have led to many novel experimental therapeutic strategies. In this review, we describe the most recent clinical treatment options and emerging experimental therapeutic strategies that have the potential to combat BCBM.

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Section: Clinical Radiotherapymentioning

confidence: 99%

Emerging treatment strategies for breast cancer brain metastasis: from translational therapeutics to real-world experience

et al. 2020

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“…We read with great interest the paper of Grkovski et al recently published in the European Journal of Nuclear Medicine and Molecular Imaging [1] investigating 18 F-fluorocholine ( 18 F-FCH) PET in patients with progressive brain metastases previously treated by stereotactic radiosurgery (SRS) and scheduled for surgical resection. Previous publications showed that changes in size and enhancement at magnetic resonance imaging (MRI) are not reliable features to distinguish between recurrence and radionecrosis [2][3][4]. In addition, advanced MRI sequences such as perfusion-weighted imaging, diffusion-weighted imaging, spectroscopy, and PET using 18 F-FDG and radiolabeled amino acids can improve the accuracy in this setting [3].…”

Section: Dear Editormentioning

confidence: 99%

“…Yet, iconographic diagnosis remains challenging. Finally, SRS is nowadays used in many centers as an alternative to surgery to treat brain metastases and showed comparable outcome in terms of local control [4,5]. In addition, SRS showed to provide a better control of irradiated metastases compared with whole brain radiotherapy [6] with a lower rate of side effects on neurocognitive function and on quality of life [7].…”

Section: Dear Editormentioning

confidence: 99%

Editorial commentary to “18F-Fluorocholine PET uptake correlates with pathologic evidence of recurrent tumor after stereotactic radiosurgery for brain metastases” by Grkovski and colleagues

Lovinfosse

Mustapha

Withofs

2019

Eur J Nucl Med Mol Imaging

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Outcomes after stereotactic radiosurgery of brain metastases in patients with malignant melanoma and validation of the melanoma molGPA

et al. 2021

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Introduction Malignant melanoma is the third most common primary in the diagnosis of brain metastases. Stereotactic radiosurgery (SRS) is a well-established treatment option in limited brain disease. We analyzed outcomes of SRS with a particular focus on the graded prognostic assessment (GPA, melanoma molGPA), prognostic factors, and toxicity. Methods We evaluated 173 brain metastases in 83 patients with malignant melanoma. All were treated with SRS median dose of 20 Gy prescribed to the 80 or 100% isodose line between 2002 and 2019. All patients were followed-up regularly, including contrast‐enhanced brain imaging as well as clinical examination, initially 6 weeks after treatment, then in quarterly follow-up. Results The median age was 61 years (range 27–80); 36 female and 47 male patients were treated. After a median follow-up of 5.7 months, median OS (overall survival) was 9.7 months 95%-KI 4.7–14.7). LC (local control) at 6 months, 12, 24 months was 89%, 86%, and 72%, respectively (median was not reached). Median DBC (distant brain control) was 8.2 months (95%-KI 4.7–11.7). For OS, a KPS ≥ 80%, a positive BRAF mutation status, a small PTV (planning target volume), the absence of extracranial metastases, as well as a GPA and melanoma molGPA > 2 were prognostic factors. In the MVA, a small PTV and a melanoma molGPA > 2 remained significant. Conclusion The present survival outcomes support the use of the disease-specific melanoma molGPA as reliable prognostic score. Favorable outcomes for SRS compared to other studies were observed. In the treatment of brain metastases of malignant melanoma patients, a multidisciplinary approach consisting of surgery, SRS, chemotherapy, and immunotherapy should be considered.

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The Expanding Role of Radiosurgery for Brain Metastases

Cited by 6 publications

References 71 publications

Emerging treatment strategies for breast cancer brain metastasis: from translational therapeutics to real-world experience

Emerging treatment strategies for breast cancer brain metastasis: from translational therapeutics to real-world experience

Editorial commentary to “18F-Fluorocholine PET uptake correlates with pathologic evidence of recurrent tumor after stereotactic radiosurgery for brain metastases” by Grkovski and colleagues

Outcomes after stereotactic radiosurgery of brain metastases in patients with malignant melanoma and validation of the melanoma molGPA

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