Management of Brain Metastases with Preoperative Radiosurgery

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Management of Brain Metastases with Preoperative Radiosurgery

February 19, 2021 Medicine and Medical Science 0

Nearly 30 percent to 54 percent of all patients are diagnosed with the most common intracranial tumor brain metastases (BMs) during or after their solid cancer treatment courses. Although the prognosis is extremely poor for BM patients, the estimated median OS is usually less than 7 months. However, nowadays, after the implementation of effective systemic and local therapies, such as surgery and radiotherapy, some patient groups can experience significantly longer survival periods (RT). Neurosurgery, whole-brain RT (WBRT), definitive SRS, postoperative SRS, systemic chemotherapy, targeted therapies, immunotherapy and their various mixtures are currently noteworthy alternatives for the management of BMs. Regarding the local treatment maneuvers, the well-recognized severe neurotoxicity of WBRT and the augmented risk for radionecrosis and leptomeningeal dissemination after postoperative SRS and the ineligibility of certain patients during the postoperative period mandated the search for safer and potentially more effective treatment alternatives for such patients’ group. In this regard, it was proposed that the novel preoperative SRS (PO-SRS) should provide at least comparable local control rates with a lower risk of radionecrosis and leptomeningeal spread. This chapter describes the conceivable rationale and available evidence for the new PO-SRS in the management armamentarium for cancer patients who have BMs.

Author (s) Details

Erkan Topkan
Department of Radiation Oncology, Baskent University Medical Faculty, Adana, Turkey.

Ahmet Kucuk
Mersin City Education and Research Hospital, Radiation Oncology Clinics, Mersin, Turkey.

Sukran Senyurek
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.

Duygu Sezen
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.

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.

Esma Didem Ikiz
Department of Radiation Oncology, Kahramanmaras Necip Fazil City Hospital, Kahramanmaras, Turkey.

Yasemin Bolukbasi
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.

Berrin Pehlivan
Department of Radiation Oncology, Bahcesehir University, Istanbul, Turkey.

Ugur Selek
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.

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