Preop Stereotactic Radiosurgery May Aid Outcomes With Resected Brain Metastases

MONDAY, July 10, 2023 (HealthDay News) -- Preoperative stereotactic radiosurgery (SRS) may be effective for patients with resected brain metastases, according to a study published online June 8 in JAMA Oncology.

Roshan S. Prabhu, M.D., from Atrium Health in Charlotte, North Carolina, and colleagues assessed outcomes and prognostic factors after preoperative SRS for patients with resected brain metastases. The analysis included 404 patients with resected brain metastases from solid cancers with a median dose to 15 Gy in one fraction or 24 Gy in three fractions delivered at a median of two days before resection.

The researchers found that the two-year cavity local recurrence rate was 13.7 percent. Cavity local recurrence risk was associated with systemic disease status, extent of resection, SRS fractionation, type of surgery (piecemeal versus en bloc), and primary tumor type. The two-year meningeal disease rate was 5.8 percent, with risk associated with the extent of resection, primary tumor type, and posterior fossa location. For adverse radiation effects, the two-year rate for any grade was 7.4 percent. Median overall survival was 17.2 months, which was most strongly predicted by systemic disease status, extent of resection, and primary tumor type.

"In this cohort study, the rates of cavity local recurrence, adverse radiation effects, and meningeal disease after preoperative SRS were found to be notably low," the authors write.

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