Stereotactic Radiotherapy for the Treatment of Brain Metastases

Kim, Dae Yong; Ahn, Yong Chan; Huh, Seung Jae; Lee, Jung Il; Nam, Do Hyun; Hong, Seung Chyul; Shin, Hyung Jin; Park, Kwan; Kim, Jong Hyun

Abstract

PURPOSE: To evaluate the clinical results of stereotactic radiosurgery (SRS) and frac- tionated stereotactic radiotherapy (FSRT) for metastatic brain tumors.
MATERIALS AND METHODS
Nineteen patients with brain metastases (34 lesions) were treated with LINAC-based SRS or FSRT with or without whole brain radiotherapy between October 1995 and February 1998. SRS was preferred to FSRT in cases with three or more lesions and poor performance status. FSRT was preferred to SRS in cases with lesions larger than 3 cm and lesions located near or at the eloquent areas such as thalamus, brain stem, and optic apparatus. Single isocenter was used both in SRS and FSRT, and the median peripheral dose in SRS was 15 Gy (range 13~20 Gy), while that in FSRT was 21 Gy (range 15~24 Gy) by 3 Gy per fraction.
RESULTS
Local control was achieved in 79% (27/34 treated lesions) and 1-year over- all survival rate was 58% with the median survival of 12 months. Lethal progressive brain metastases, both local and regional, were in four patients (27% of all deaths). No significant differences in local control and survival was observed with histology, age, sex, performance status, tumor volume, number of lesions, or treatment modality. Unacceptable acute or late complications did not occur.
CONCLUSION
Stereotactic radiotherapy including SRS and FSRT is effective, non-invasive therapy for brain metastases. This study suggests that stereotactic radiotherapy might be an alternative to surgical resection in selected patients of brain metastases.