Surgical resection and postoperative radiosurgery versus staged radiosurgery for large brain metastases

Dohm, Ammoren; Hughes, Ryan T.; Wheless, W.H.; LeCompte, M.C.; Lanier, C.M.; Ruiz, Jimmy; Watabe, Kounosuke; Xing, Fei; Su, Jing; Cramer, Christina K.; Laxton, Adrian W.; Tatter, Stephen B.; Chan, Michael D.

doi:10.1007/s11060-018-03008-8

Cited by 31 publications

(25 citation statements)

References 33 publications

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“…There was no significant difference in age, KPS, RPA classification, tumor type, and number of tumors between the SR and SRS groups in 9 studies. The RPA score was higher in the SR group than in the SRS group in 4 studies [7, 16-18]. Mean age was younger in the SR group than the SRS group in 3 studies [17, 19, 20].…”

Section: Resultsmentioning

confidence: 99%

Comparison of Surgical Resection and Stereotactic Radiosurgery in the Initial Treatment of Brain Metastasis

Liu

Liang

2020

Stereotact Funct Neurosurg

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Background: Brain metastasis (BM) is the most common brain malignancy and a common cause of death in cancer patients. However, the relative outcome-related advantages and disadvantages of surgical resection (SR) and stereotactic radiosurgery (SRS) in the initial treatment of BM are controversial. Method: We systematically reviewed the English language literature up to March 2020 to compare the efficacy of SR and SRS in the initial treatment of BM. We identified cohort studies from the Cochrane Library, PubMed, and EM-BASE databases and conducted a meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Twenty cohort studies involving 1,809 patients were included. Local control did not significantly differ between the SR and SRS groups overall (hazard ratio [HR] 1.02, 95% confidence interval (CI) 0.64-1.64, p = 0.92; I 2 = 54%, p = 0.03) or in subgroup analyses of SR plus SRS vs. SRS alone, SR plus whole brain radiation therapy (WBRT) versus SRS plus WBRT, or SR plus WBRT versus SRS alone. Distant intracranial control did not significantly differ between the SR and SRS groups overall (HR 0.78, 95% CI 0.38-1.60, p = 0.49; I 2 = 61%, p = 0.03) or in subgroup analyses of SR plus SRS versus SRS alone or SR plus WBRT versus SRS alone. In addition, overall survival (OS) did not significantly differ in the SR and SRS groups (HR 0.91, 95% CI 0.65-1.27, p = 0.57; I 2 = 47%, p = 0.09) or in subgroup analyses of SR plus SRS versus SRS alone, SR plus WBRT versus SRS alone or SR plus WBRT versus SRS plus WBRT. Conclusion: Initial treatment of BM with SRS may offer comparable local and distant intracranial control to SR in patients with single or solitary BM. OS did not significantly differ between the SR and SRS groups in people with single or solitary BM.

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Section: Resultsmentioning

confidence: 99%

Comparison of Surgical Resection and Stereotactic Radiosurgery in the Initial Treatment of Brain Metastasis

Liu

Liang

2020

Stereotact Funct Neurosurg

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“…It is increasingly recognised that surgery is independently increasing the risk of leptomeningeal dissemination [3,39,40]. This risk could be mitigated by using SRS alone [41] or, if surgery is unavoidable, by treating with preoperative SRS [42,43]. As compared with postoperative SRS, preoperative SRS has the potential benefit of an easier to define target and smaller treatment volume, and lower rates of radionecrosis have been observed [44].…”

Section: New Directions In Stereotactic Radiosurgerymentioning

confidence: 99%

Stereotactic Radiosurgery and Stereotactic Body Radiotherapy in the Management of Oligometastatic Disease

et al. 2020

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“…Figure 2D and Table 3). Surgery or SRS of oligo metastasis (1-4 lesions), on the other hand, is considered as an effective treatment option [6][7][8] with generally equivalent clinical outcome, [19][20][21] though higher incidence of late recurrences has been observed in the SRS group. 22 Recently, SRS of up to 10 lesions has been considered feasible and appropriate.…”

Section: At the Discretion Of Attending Physicians Patients Underwentmentioning

confidence: 99%

Effects of systemic therapy and local therapy on outcomes of 873 breast cancer patients with metastatic breast cancer to brain: MD Anderson Cancer Center experience

Gao

Wang

Suki

et al. 2020

Intl Journal of Cancer

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Outcomes of treatments for patients with breast cancer brain metastasis (BCBM) remain suboptimal, especially for systemic therapy. To evaluate the effectiveness of systemic and local therapy (surgery [S], stereotactic radiosurgery [SRS] and whole brain radiotherapy [WBRT]) in BCBM patients, we analyzed the data of 873 BCBM patients from 1999 to 2012. The median overall survival (OS) and time to progression in the brain (TTP-b) after diagnosis of brain metastases (BM) were 9.1 and 7.1 months, respectively. WBRT prolonged OS in patients with multiple BM (hazard ratio [HR],

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Surgical resection and postoperative radiosurgery versus staged radiosurgery for large brain metastases

Cited by 31 publications

References 33 publications

Comparison of Surgical Resection and Stereotactic Radiosurgery in the Initial Treatment of Brain Metastasis

Comparison of Surgical Resection and Stereotactic Radiosurgery in the Initial Treatment of Brain Metastasis

Stereotactic Radiosurgery and Stereotactic Body Radiotherapy in the Management of Oligometastatic Disease

Effects of systemic therapy and local therapy on outcomes of 873 breast cancer patients with metastatic breast cancer to brain: MD Anderson Cancer Center experience

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