Preoperative Radiosurgery in Management of Brain Metastases

Main Article Content

Erkan Topkan
Ahmet Kucuk
Sukran Senyurek
Duygu Sezen
Nulifer Kilic Durankus
Eyub Yasar Akdemir
Esma Didem Ikiz
Yasemin Bolukbasi
Berrin Pehlivan
Ugur Selek

Abstract

Brain metastases (BMs), the most frequent intracranial tumors, are diagnosed in approximately 30% of all adult patients over the span of planned treatment against a broad spectrum of solid cancers. The prognosis of patients presenting with BM is bleak with an expected median OS of only 4-7 months. However, some particular patients’ groups may enjoy longer survival durations with effective systemic and local therapies. At present, the feasible alternatives for active management of BMs typically include the whole-brain radiotherapy (WBRT), surgery, definitive SRS, postoperative SRS, systemic chemotherapy, targeted therapies, and their combination variants. Considering the local treatment, the severe neurotoxic effects of WBRT, and the increased risk for radionecrosis and leptomeningeal dissemination after postoperative SRS and together with the ineligibility of certain patients during the postoperative period prompted the energetic quest of alternative treatment strategies for such patients. In this respect, the novel preoperative SRS (PO-SRS) was proposed to provide at least equivalent local control rates with lesser radionecrosis and leptomeningeal dissemination risk. Respecting the scarcity of related literature, the present review aimed to meticulously detail theplausible rationale and accessible evidence for the novel PO-SRS in the management of patients presenting with BMs.

Keywords:
Brain metastasis, postoperative stereotactic radiosurgery, local control, survival, complications.

Article Details

How to Cite
Topkan, E., Kucuk, A., Senyurek, S., Sezen, D., Durankus, N. K., Akdemir, E. Y., Ikiz, E. D., Bolukbasi, Y., Pehlivan, B., & Selek, U. (2020). Preoperative Radiosurgery in Management of Brain Metastases. Journal of Cancer and Tumor International, 10(1), 1-11. https://doi.org/10.9734/jcti/2020/v10i130117
Section
Review Article

References

Davis FG, Dolecek TA, McCarthy BJ, et al. Toward determining the lifetime occurrence of metastatic brain tumors estimated from 2007 United States cancer incidence data. Neuro-Oncol. 1997;14: 1171-7.

Ostrom QT, Gittleman H, Fulop J, et al. CBTRUS Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2008-2012.NeuroOncol. 2015;17(Suppl 4):iv1-iv62

Routman DM, Yan E, Vora S, et al. preoperativestereotactic radiosurgery for brainmetastases. Front Neurol. 2018;9: 959.

Nayak L, Lee EQ, Wen PY. Epidemiology of brain metastases. CurrOncol Rep. 2011;14:48-54 .

Billing PS, Miller DL, Allen MS, Deschamps C, Trastek VF, Pairolero PC. Surgical treatment of primary lung cancer with synchronous brain metastases. J ThoracCardiovasc Surg. 2001;122(3):548-53.

Johung KL, Yeh N, Desai NB, et al. Extended survival and prognostic factors for patients with ALK-rearranged non-small-cell lung cancer and brain metastasis. J ClinOncol. 2016;34(2):123-9.

Arbit E, Wroński M, Burt M, Galicich JH. The treatment of patients with recurrent brain metastases. A retrospective analysis of 109 patients with non small cell lung cancer. Cancer. 1995;76(5):765‐73.

Kocher M, Soffietti R, Abacioglu U, et al. Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases: results of the EORTC 22952-26001 study. J ClinOncol. 2011;29(2):134–41.

Borgelt B, Gelber R, Kramer S, et al. The palliation of brain metastases: Final results of the first two studies by the Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys. 1980;6(1):1-9.

Gaspar L, Scott C, Rotman M, et al. Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat OncolBiol Phys. 1997;37(4):745-51.

Sperduto PW, Berkey B, Gaspar LE,Mehta M, Curran W. A new prognostic index and comparison to three other indices for patients with brain metastases: an analysis of 1,960 patients in the RTOG database. Int J Radiat OncolBiol Phys. 2008; 70(2):510-514.

Patchell RA, Tibbs PA, Walsh JW, et al. A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med. 1990;322(8):494-500.

Patchell RA, Tibbs PA, Regine WF, et al. Postoperative radiotherapy in the treatment of single metastases to the brain. JAMA. 1998;280(17):1485-9.

Andrews DW, Scott CB, Sperduto PW, et al. Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: Phase III results of the RTOG 9508 randomised trial. Lancet North Am Ed.. 2004;363(9422):1665-72.

Aoyama H, Shirato H, Tago M, et al. Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases. JAMA. 2006;295(21):2483-91.

Chang EL, Wefel JS, Hess KR, et al. Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial. Lancet Oncol. 2009;10(11):1037-44.

Brown PD, Jaeckle K, Ballman KV, et al. Effect of radiosurgery alone vs radiosurgery with whole brain radiation therapy on cognitive function in patients with 1 to 3 brain metastases. JAMA. 2016;316(4):401-9.

Kocher M, Soffietti R, Abacioglu U, et al. Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases: results of the EORTC 22952-26001 Study. J ClinOncol. 2011;29(2):134-41.

Soffietti R, Kocher M, Abacioglu UM, et al. A European Organisation for Research and Treatment of Cancer phase III trial of adjuvant whole-brain radiotherapy versus observation in patients with one to three brain metastases from solid tumors after surgical resection or radiosurgery: Quality-of-life results. J Clin Oncol. 2013;31(1):65-72.

Quigley MR, Bello N, Jho D, et al. Estimating the additive benefit of surgical excision to stereotactic radiosurgery in the management of metastatic brain disease. Neurosurgery. 2015;76(6):707-13.

Prabhu RS, Press RH, Patel KR, et al. Single-fraction stereotactic radiosurgery (SRS) alone versus surgical resection and SRS for large brain metastases: A multi-institutional analysis. Int J Radiat OncolBiol Phys. 2017;99(2):459-67.

Prabhu RS, Patel KR, Press RH, et al. Preoperativevspostoperativeradiosurgery for resectedbrainmetastases: A review. Neurosurgery. 2019;84(1):19-29.

Karlovits BJ, Quigley MR, Karlovits SM, et al. Stereotactic radiosurgery boost to the resection bed for oligometastatic brain disease: challenging the tradition of adjuvant whole-brain radiotherapy. Neurosurg Focus. 2009;27:E7.

Jensen CA, Chan MD, McCoy TP, et al. Cavity-directed radiosurgery as adjuvant therapy after resection of a brain metastasis. J. Neurosurg. 2011;114: 158591.

Iwai Y, Yamanaka K, Yasui T. Boost radiosurgery for treatment of brain metastases after surgical resections. Surg Neurol. 2008;69:181-6.

Do L, Pezner R, Radany E, et al. Resection followed by stereotactic radiosurgery to resection cavity for intracranial metastases. Int J RadiatOncolBiol Phys. 2009;73:486-91.

Ojerholm E, Lee JY, Thawani JP, et al. Stereotactic radiosurgery to the resection bed for intracranial metastases and risk of leptomeningealcarcinomatosis. J. Neurosurg. 2014;121(Suppl.):75-83.

Prabhu R, Shu HK, Hadjipanayis C, et al. Current dosing paradigm for stereotactic radiosurgery alone after surgical resection of brain metastases needs to be optimized for improved local control. Int J RadiatOncolBiol Phys. 2012;83:e61-6.

Ogiwara H, Kalakota K, Rakhra SS, et al. Intracranial relapse rates and patterns, and survival trends following post-resection cavity radiosurgery for patients with single intracranial metastases. J Neuro-Oncol. 2012;108:141-6.

Quigley MR, Fuhrer R, Karlovits S, Karlovits B, Johnson M. Single session stereotactic radiosurgery boost to the post-operative site in lieu of whole brain radiation in metastatic brain disease. J Neuro-Oncol. 2008;87:327-32.

Hartford AC, Paravati AJ, Spire WJ, et al. Postoperative stereotactic radiosurgery without whole-brain radiation therapy for brain metastases: Potential role of preoperative tumor size. Int J RadiatOncolBiol Phys. 2013;85:650-5.

Brennan C, Yang TJ, Hilden P, et al. A phase 2 trial of stereotactic radiosurgery boost after surgical resection for brain metastases. Int J RadiatOncolBiol Phys. 2014;88:130-6.

Minniti G, Esposito V, Clarke E, et al. Multidose stereotactic radiosurgery (9Gy x 3) of the postoperative resection cavity for treatment of large brain metastases. Int J RadiatOncolBiol Phys. 2013;86:623-9.

Steinmann D, Maertens B, Janssen S, et al. Hypofractionated stereotactic radiotherapy (hfSRT) after tumour resection of a single brain metastasis: report of a single-centre individualized treatment approach. J Cancer Res ClinOncol. 2012;138:1523-9.

Soltys SG, Adler JR, Lipani JD, et al. Stereotactic radiosurgery of the postoperative resection cavity for brain metastases. Int J RadiatOncolBiol Phys. 2008;70:187-93.

Choi CY, Chang SD, Gibbs IC, et al. Stereotactic radiosurgery of the postoperative resection cavity for brain metastases: prospective evaluation of target margin on tumor control. Int J RadiatOncolBiol Phys. 2012;84:336-42.

Jagannathan J, Yen CP, Ray DK, et al. Gamma knife radiosurgery to the surgical cavity following resection of brain metastases. J Neurosurg. 2009;111:431-8.

Traylor JI, Habib A, Patel R, et al. Fractionated stereotactic radiotherapy for local control of resected brainmetastases. J Neurooncol. 2019;144(2):343-50.

McDermott DM, Hack JD, Cifarelli CP, Vargo JA. Tumor cavity recurrence after stereotactic radiosurgery of surgically resected brainmetastases: Implication of Deviations from Contouring Guidelines. StereotactFunctNeurosurg. 2019;97(1):24-30.

Ayas AW, Grau S, Jablonska K, et al. Postoperative local fractionated radiotherapy for resected single brainmetastases.Strahlenther Onkol. 2018; 194(12):1163-70.

Brown PD, Ballman KV, Cerhan JH, et al. Postoperative stereotactic radiosurgery compared with whole brain radiotherapy for resected metastatic brain disease (NCCTG N107C/CEC•3): A multicentre, randomised, controlled, phase 3 trial. Lancet Oncol. 2017;18(8):1049-60.

Minniti G, Scaringi C, Lanzetta G, et al. Comparative effectiveness of multi-fraction stereotactic radiosurgery for surgically resected or intact large brainmetastases from non-small-cell lung cancer (NSCLC). Lung Cancer. 2019;132:119-25.

Mahajan A, Ahmed S, McAleer MF, Weinberg JS, Li J, Brown P. Postoperative stereotactic radiosurgery versus observation for completely resected brain metastases: A single-centre, randomised, controlled, phase 3 trial. Lancet Oncol. 2017;18:1040-8.

Kohutek ZA, Yamada Y, Chan TA, et al. Long-term risk of radionecrosis and imaging changes after stereotactic radiosurgery for brain metastases. J NeuroOncol. 2015; 125:149-56.

Patel KR, Prabhu RS, Kandula S, et al. Intracranial control and radiographic changes with adjuvant radiation therapy for resected brain metastases: whole brain radiotherapy versus stereotactic radiosurgery alone. J Neurooncol 2014;120:657-63.

Udovicich C, Phillips C, Kok DL, et al. Neoadjuvant stereotactic radiosurgery: a further evolution in the management of brain metastases. CurrOncol Rep. 2019; 4;21(8):73.

Lazarev S, McGee H, Moshier E, et al. Preoperative vs postoperative radiation therapy in localized soft tissue sarcoma: nationwide patterns of care and trends in utilization. PractRadiatOncol. 2017;7:e507-16.

Sauer R, Becker H, Hohenberger W, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med. 2004;351:1731-40.

Van Tienhoven G, Versteijne E, SukerM, et al. Preoperative chemoradiotherapy versus immediate surgery for resectable and borderline resectable pancreatic cancer (PREOPANC-1): A randomized, controlled, multicenter phase III trial. J ClinOncol. 2018; 36(18 Suppl):LBA4002.

van Hagen P, Hulshof MC, van Lanschot JJ, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366:2074-84.

Asher AL, Burri SH, WigginsWF, et al. A new treatment paradigm: neoadjuvant radiosurgery before surgical resection of brain metastases with analysis of local tumor recurrence. Int J RadiatOncolBiol Phys. 2014;88(4):899-906.

Patel KR, Burri SH, Asher AL, et al. Comparing preoperative with postoperative stereotactic radiosurgery for resectable brain metastases: A multi-institutional analysis. Neurosurgery. 2016;79(2):279–85.

Patel KR, Burri SH, Boselli D, et al. Comparing pre-operative stereotactic radiosurgery (SRS) to post-operative whole brain radiation therapy (WBRT) for resectable brain metastases: A multi-institutional analysis. J Neuro-Oncol. 2017; 131(3):611-8.

Prabhu RS, Miller KR, Asher AL, et al. Preoperative stereotactic radiosurgery before planned resection of brain metastases: updated analysis of efficacy and toxicity of a novel treatment paradigm. J Neurosurg. 2018:1-8.

Shaw E, Scott C, Souhami L, et al. Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: final report of RTOG protocol 90-05. Int J RadiatOncolBiol Phys. 2000;47(2):291-8.

YamamotoM, Kawabe T, Barfod BE, Sato Y, Urakawa Y. Can preoperative GKRS prevent meningeal dissemination in brain met patients? A case-matched study. International Stereotactic Radiosurgery Society Congress (10th) 2011.

Routman DM, Yan E, Vora S, et al. preoperative stereotactic radiosurgery for brain metastases. Front Neurol. 2018;9: 959.

Yang R, Duan C, Yuan L, et al. Inhibitors of HIF-1alpha and CXCR4 mitigate the development of radiation necrosis in mouse brain. Int J RadiatOncolBiol Phys. 2018;100:1016-25.

Soliman H, Ruschin M, Angelov L, Brown PD, Chiang VLS, Kirkpatrick JP. Consensus contouring guidelines for postoperative completely resected cavity stereotactic radiosurgery for brain metastases. Int J Rad OncolBiol Phys. 2018;100:436-42.

Udovicich C, Phillips C, Kok DL, et al. Neoadjuvantstereotactic radiosurgery: A further evolution in the management of brain Metastases. CurrOncol Rep. 2019; 21(8):73.

Vellayappan BA, Doody J, Vandervoort E, et al. Pre-operative versus post-operative radiosurgery for brain metastasis: effects on treatment volume and interobserver variability. J Radiosurg SBRT. 2018;5(2): 89-97.

Seymour ZA, Fogh SE, Westcott SK, et al. Interval from imaging to treatment delivery in the radiation surgery age: how long is too long? Int J RadiatOncolBiol Phys. 2015;93(1):126-32.

Alghamdi M, Hasan Y, Ruschin M, et al. Stereotactic radiosurgery for resected brain metastasis: cavity dynamics and factors affecting its evolution. J Radiosurg SBRT. 2018;5(3):191-200.

Yamamoto M. When serendipity meets creativity. Journal of radiosurgery and SBRT. 2011;1(2).

Clark GM, Stewart JG, Guthrie BL, et al. Phase 1 dose escalation/de-escalation study of preoperative stereotactic radiosurgery for brain metastases: Preliminary acute toxicity and dosimetric analysis. Int J RadiatOncolBiol Phys. 2013; 87(2):S271-S2.

Bredel M, Stewart J. Bmet-35. Rad 1002: phase I dose finding study of pre-operative stereotactic radiosurgery for brain metastases. Neuro-oncology. 2016; 18(suppl-6):vi34-vi.

Vetlova E, Golbin DA, Golanov AV, Potapov AA, Banov SM, Antipina N, et al. Preoperative stereotactic radiosurgery of brain metastases: Preliminary results. Cureus. 2017;9(12):e1987.