Treatment of Cerebral Metastases from Breast Cancer with Stereotactic Radiosurgery

Abstract

SRS alone is an effective treatment for patients with one to three brain metastases from breast cancer. A randomized trial should be performed to evaluate whether WBRT is a necessary component in the primary treatment of these patients. Salvage SRS is an effective therapy option after WBRT.

Brain Metastases from Epithelial Ovarian Cancer: A Review of the Literature

“…Many of the lesions slowly decrease in size and dissolve following treatment with gamma-knife SRS [56]. Combs et al [57] studied the impact of WBRT and focal boost SRS versus SRS alone in patients with brain metastases from primary breast cancer. They reported that survival was longer in patients receiving SRS only than in those receiving WBRT plus SRS as a focal boost.…”

Chemoradiotherapy: Radiation Total Dose and Fractionation

“…Combs et al [ 105 ] do not report any toxicity in 32 GBM treated with 17 Gy. The higher rate of severe effect reported in the fi rst study might be due to the largest treatment volume (28 cm 3 vs. 10.1 and 10 cm 3 ).…”

Outcomes Following Gamma Knife for Metastases

“…A single-institution review of 105 patients with 1-4 brain metastases, however, showed that the addition of WBRT to SRS did not result in improvement in survival or local control if salvage therapy was available for recurrence after SRS alone (Sneed, 1999). This lack of a statistically significant difference in overall survival was confirmed by seven other retrospective cohort studies (Chidel, 2000;Hoffman, 2001;Jawahar, 2002;Noel, 2003;Pirzkall, 1998;Sneed, 2002;Varlotto, 2005) and one prospective cohort study (Li, 2000), while one study showed a survival benefit for SRS alone (Combs, 2004) and another showed a survival benefit for SRS+WBRT (Wang, 2002). Among these 10 retrospective cohort studies, only one reported a statistically significant worsening in local tumor control for patients treated with SRS alone compared to SRS+WBRT (Varlotto, 2005).…”