Tumor Cavity Stereotactic Radiosurgery for Resected Brain Metastases
Yasemin Bolukbasi
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey and Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
Ugur Selek *
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey and Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
Duygu Sezen
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey and Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
Nulifer Kilic Durankus
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.
Eyub Yasar Akdemir
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.
Sukran Senyurek
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.
Ahmet Kucuk
Mersin City Education and Research Hospital, Radiation Oncology Clinics, Mersin, Turkey.
Berrin Pehlivan
Department of Radiation Oncology, Bahcesehir University, Istanbul, Turkey.
Erkan Topkan
Department of Radiation Oncology, Baskent University, Adana, Turkey.
*Author to whom correspondence should be addressed.
Abstract
Stereotactic radiosurgery (SRS) has been utilized broadly for brain metastases not only for intact ones but as well as of late for the postoperative cavity of metastases after surgery, due to the advantages of SRS to preserve neurocognitive functions, maintain local control and prescribe the treatment in a short time frame. Randomized trials have proven the safety and efficacy of cavity SRS compared to observation. As WBRT offers no survival advantage in comparison to SRS and frequent monitorization with brain MRIs for early salvage upon failure, there has been a revolution in clinical approach for patients with limited intact brain metastases to treat with SRS only and omit WBRT. Likewise, the postoperative cavity SRS for brain metastases has gained a growing reputation. In this review, we summarize the proof for evidence-based optimization in the postoperative setting of the surgically removed brain metastases.
Keywords: Brain metastases, stereotactic radiosurgery, neurosurgery, postoperative cavity radiosurgery, toxicity, efficacy, prognosis