Brain Tumor Res Treat.  2023 Oct;11(4):246-253. 10.14791/btrt.2023.0032.

Treatment Outcome of the Brain Metastases in Peri-Rolandic Area: Comparison Between Surgery and Stereotactic Radiosurgery

• Jung JH
• Park K
• Kim EY
• Yoo CJ
• Yee GT
• Kim WK
• Shin DW

• KMID: 2547413
• DOI: http://doi.org/10.14791/btrt.2023.0032

Abstract

Background
Brain metastases of peri-Rolandic area is crucial as it directly impacts the quality of life for cancer patients. Surgery or stereotactic radiosurgery (SRS) is considered for peri-Rolandic brain metastases as for other brain metastases. However, the benefit of each treatment modality on functional outcome has not been clearly defined for this tumor. The purpose of this study is to compare the functional course of each treatment and to suggest an effective treatment for patients’ quality of life.
Methods
Fifty-two patients who had undergone SRS or surgery for brain metastasis confirmed by enhanced MRI were enrolled retrospectively. Overall survival (OS), progression free survival (PFS), and functional outcomes were estimated using the Kaplan-Meier method, univariate, multivariate analysis, and Cox proportional hazards regression.
Results
Median OS and PFS were 13.3 months and 8.9 months in our study population. Treatment modalities were not significant factors for OS and PFS. Extracranial systemic cancer progression was significant factor for both parameters (p=0.030 for OS and p=0.040 for PFS). Median symptom improvement (improvement of at least 1 grade after surgery compared to preoperative state) time was significantly shorter in surgery group than in the SRS group (10.5 days vs. 37.5 days, p=0.034).
Conclusion
Surgery for brain metastases can contribute to a positive quality of life for the remain-ing duration of the patient’s life.

Keyword

Brain neoplasms; Neoplasm metastasis; Motor cortex; Radiosurgery; Neurosurgery; Functional status

Figure

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  Fig. 1 Flow diagram of patient groups. BMs, brain metastases; SRS, stereotactic radiosurgery.

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  Fig. 2 Kaplan-Meier’s survival curve for overall survival (A) and progression-free survival (B) of each group. SRS, stereotactic radiosurgery.

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  Fig. 3 Complications after radiosurgery. ETC, poor oral intakes, intractable hiccups, tremor, stomatitis, lymphedema.

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