Stereotactic radiosurgery for multiple brain metastases

被引:13
作者
Lam, Tai-Chung [1 ]
Sahgal, Arjun [2 ]
Chang, Eric L. [3 ]
Lo, Simon S. [4 ]
机构
[1] Harvard Univ, Sch Med, Dana Farber Canc Inst, Dept Radiat Oncol,Brigham & Womens Hosp, Boston, MA 02115 USA
[2] Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Radiat Oncol, Toronto, ON, Canada
[3] Univ So Calif, Keck Sch Med, Dept Radiat Oncol, Norris Canc Hosp,Keck Hosp,Los Angeles Cty Univ S, Los Angeles, CA 90033 USA
[4] Case Comprehens Canc Ctr, Univ Hosp Seidman Canc Ctr, Dept Radiat Oncol, Cleveland, OH 44106 USA
关键词
brain metastases; gamma knife system; neurocognitive function; stereotactic radiosurgery; whole brain radiation therapy; GAMMA-KNIFE RADIOSURGERY; QUALITY-OF-LIFE; BREAST-CANCER; PROGNOSTIC-FACTORS; RADIATION-THERAPY; CEREBRAL METASTASES; SURGICAL RESECTION; COST-EFFECTIVENESS; SALVAGE TREATMENT; LUNG-CANCER;
D O I
10.1586/14737140.2014.940325
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Stereotactic radiosurgery (SRS) alone has become one of the treatment options for patients with 1-4 metastases as the detrimental effects of whole brain radiation therapy on neurocognition and quality of life are becoming well known. Multiple randomized control trials also failed to show overall survival benefit of adding whole brain radiation therapy to SRS. However, the role of SRS in multiple brain metastases, especially those with >= 4 tumors, remains controversial. The literature is emerging, and the limited evidence suggests that the local control benefit is independent of the number of metastases, and that patients with more than four brain metastases have similar overall survival compared to those with 2-4 tumors. This review aims at summarizing the current evidence of SRS for multiple brain metastases, divided into limited (2-3) and multiple (>= 4) lesions. It also reviews the technical aspects and cost-effectiveness of SRS.
引用
收藏
页码:1153 / 1172
页数:20
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