Radiosurgery for brain métastases

The role of stereotactic radiosurgery in the managment of brain métastases (mets) was evaluated. Between October 1991 and junuary 1995 250 patients underwent linear accelerator based stereotactic radiosurgery for brain mets identified by CT or MRI. In this paper we present a study on seventy patients. 48 cases had single and 22 two brain mets at first radiosurgical treatment. Exclusion criteria were: 1) karnofsky performance scale (KPS) less than 60, 2) evidence of acute neurologic deterioration and lesion size more than 4 cm. Whole brain radiotherapy was given to 18 patients. The median survival was 15 months (1-52) for patients with one mets and 13 (1-45) for patients with two mets. Stereotactic radiosurgery was also associated with improved quality of life as measured by KPS. The median survival was not longer in patients treated with whole brain radiotherapy and comparable to the neurosurgical treatment alone. The results of this analysis show that radiosurgery is an effective and safe, minimally invasive treatment for brain mets and may be directed to lesions not treatable by conventional surgery.