Three irradiation treatment options including radiosurgery for brain metastases from primary lung cancer

Local control after fractionated stereotactic radiation therapy for brain metastases

“…Several SRS studies have found an association between local control and dose to the tumor [17,20,[25][26][27]. Unlike SRS, where the prescription dose is limited to one fraction and generally based on tumor size [5], there are a variety of different doses and fractionations reported for SRT; selected studies are summarized in Table 3.…”

Stereotactic Radiotherapy Reduces Treatment Cost While Improving Overall Survival and Local Control Over Standard Fractionated Radiation Therapy for Medically Inoperable Non-Small-Cell Lung Cancer

“…The efficacy of stereotactic radiosurgery is best known for its success in treating benign, malignant, and metastatic brain tumors, showing intracranial tumor control rates in the range of 90%. 4 In addition to the excellent local control observed with intracranial radiosurgery, there are quality of life improvements offered with the single fraction nature of the treatment and avoidance of the use of whole brain radiotherapy. In 1995, Blomgren et al introduced a new stereotactic treatment technique applying radiosurgical technology to areas outside the brain, stereotactic radiotherapy, or stereotactic body radiotherapy (SBRT).…”

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).…”

“…Despite their inherent biases, retrospective studies have raised the possibility that the SRS-alone approach may be viable for a limited number of metastases. When first proposed, many studies demonstrated that freedom from intracranial disease progression at 1 year, predominantly at sites distant than those treated with SRS, was significantly worse for SRS alone than SRS+WBRT (Chidel, 2000;Hoffman, 2001;Noel, 2003;Pirzkall, 1998). 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).…”