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01-04-2016 | Review Article - Brain Tumors

Treatment of high numbers of brain metastases with Gamma Knife radiosurgery: a review

Authors: Mustafa Aziz Hatiboglu, Saffet Tuzgen, Kerime Akdur, Eric L. Chang

Published in: Acta Neurochirurgica | Issue 4/2016

Abstract

Effectiveness of stereotactic radiosurgery (SRS) has been shown in patients with one to four brain metastases. Work has been done to evaluate the role of SRS alone treatment without whole-brain radiation therapy in patients with more than four metastases. A recent multiinstitutional JLGK 0901 prospective study revealed the class-2 evidence that SRS without whole-brain radiation therapy is an effective treatment for patients up to 10 metastatic lesions. Several retrospective studies exist to show the efficacy and safety of SRS for patients with even more than 10 lesions. However, patient selection is very critical for SRS alone treatment. The PubMed database was searched using combinations of search terms and synonyms for multiple brain metastases, Gamma Knife and SRS published between January 1, 2005 and January 1, 2015 in order to address the effectiveness of Gamma Knife for patients with multiple brain metastases. Good performance status, controlled primary disease, total treated tumor volume of 15 cm³ or less have been found to be significant predictors for survival among patients with two or more brain lesions. The data suggest that SRS can be used and whole brain radiation therapy can be withheld in selected patients with multiple lesions to avoid acute or chronic adverse effects, especially neurocognitive decline, without causing survival disadvantage. In this review, we assessed the evidence for SRS treatment of patients with multiple brain metastases.

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Title: Treatment of high numbers of brain metastases with Gamma Knife radiosurgery: a review
Authors: Mustafa Aziz Hatiboglu
Saffet Tuzgen
Kerime Akdur
Eric L. Chang
Publication date: 01-04-2016
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 4/2016
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-016-2707-6

At a glance: The STEP trials

Springer Medicine

Treatment of high numbers of brain metastases with Gamma Knife radiosurgery: a review

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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