Authors: Peter Lindvall Per Bergström PerOlov Löfroth A Tommy Bergenheim
Publish Date: 2009/04/24
Volume: 151, Issue: 9, Pages: 1053-
Abstract
The standard treatment of solitary brain metastases previously has been tumour resection in combination with wholebrain radiation therapy WBRT Stereotactic radiotherapy has emerged as a noninvasive treatment option especially for small brain metastases We now report our results on resection + WBRT or hypofractionated stereotactic irradiation HCSRT in the treatment of solitary brain metastasesBetween 1993 and 2004 patients with metastatic cancer and solitary brain metastases were selected for surgical resection + WBRT or HCSRT alone at the Umeå University Hospital Fiftynine patients were treated with surgical resection + WBRT 34 male 25 female mean age 633 years Fortyseven patients were treated with HCSRT alone 15 male 32 female mean age 649 yearsIn patients followed radiologically 28 treated with resection + WBRT showed a local recurrence after a median time of 80 months whereas there was a lack of local control in 16 in the HCSRT group after a median time of 30 months There was a significantly longer survival time for patients treated with resection + WBRT median 79 mean 129 months compared to HCSRT median 50 mean 76 months Even in patients with a tumour volume 10 cc there was a significantly longer survival in favour of resection + WBRT median 84 mean 174 months compared to HCSRT median 50 mean 79 monthsThis retrospective and nonrandomised study indicates that surgical resection in combination with WBRT may be an option even for small brain metastases suitable for treatment with HCSRT Since survival and local control following resection + WBRT was at least as favourable as compared to HCSRT alone tumour location and expected neurological outcome may be the strongest aspect when selecting treatment modality
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