Feature | May 06, 2015

Repeat Stereotactic Radiosurgery for Cerebral Metastases Doesn’t Impact Survival

Median overall survival comparable with single or multiple rounds of SRS

cerebral metastases, stereotactic radiosurgery, SRS, survival, AANS, Marshall

May 6, 2015 — Leksell Radiosurgery Award winner Deborah C. Marshall presented her research, “Survival Patterns of Patients with Cerebral Metastases after Multiple Rounds of Stereotactic Radiosurgery” (SRS), at the 2015 American Association of Neurological Surgeons Annual Scientific Meeting.

With escalating focus on cost containment, there is increasing scrutiny on the practice of multiple rounds of SRS for patients suffering from subsequent brain metastases distant to the initial site. A major concern is that such recurrence may be a prognostic indicator of poor overall survival.

Marshall’s study retrospectively analyzed outcomes of 801 patients with 3,683 brain metastases from primary breast, colorectal, lung, melanoma and renal cancers consecutively treated at the University of California, San Diego/San Diego Gamma Knife Center (UCSD/SDGKC). The analysis compared the survival pattern of patients who underwent a single round (n=643) versus multiple rounds (n=158) of SRS for subsequent brain metastases. Multivariate analyses were performed to control for known prognostic variables, including age, Karnofsky performance status, number of metastases, cumulative tumor volume and systemic disease status.

No significant difference in median survival from the time of final round of SRS was found for patients undergoing one, two, three or >four rounds of SRS (median survival of 167, 202, 129 and 127 days, respectively, p=0.49).

Median intervals between treatments consistently ranged from 140 to 178 days, irrespective of rounds of SRS (p=0.25). Patients who underwent multiple rounds of SRS tended to be younger, have achieved systemic disease control, harbor lower cumulative tumor volume but have an increased number of metastases (p-values <0.001, <0.001, <0.001 and 0.02, respectively). Multivariate analysis of pertinent clinical variables revealed that additional rounds of SRS did not significantly influence overall survival (p<0.001).

For judiciously selected patients, median overall survival was comparable for brain metastases patients who underwent single or multiple rounds of SRS. The decision of whole brain radiation therapy (WBRT) versus multi-round SRS should be tailored to the clinical condition of patient based on judgment of the treating physician.

For more information: www.aans.org

Related Content

Older Biologic Age Linked to Elevated Breast Cancer Risk
News | Women's Health | March 19, 2019
Biologic age, a DNA-based estimate of a person’s age, is associated with future development of breast cancer, according...
HeartFlow Analysis Successfully Stratifies Heart Disease Patients at One Year
News | CT Angiography (CTA) | March 19, 2019
Late-breaking results confirm the HeartFlow FFRct (fractional flow reserve computed tomography) Analysis enables...
PET Scans Show Biomarkers Could Spare Some Breast Cancer Patients from Chemotherapy
News | PET Imaging | March 18, 2019
A new study positron emission tomography (PET) scans has identified a biomarker that may accurately predict which...
SyncVision iFR Co-registration from Philips Healthcare maps iFR pressure readings onto angiogram.

SyncVision iFR Co-registration from Philips Healthcare maps iFR pressure readings onto angiogram. Results from an international study presented at #ACC19 show that pressure readings in coronary arteries may identify locations of stenoses remaining after cardiac cath interventions.

Feature | Cardiac Imaging | March 18, 2019 | By Greg Freiherr
As many as one in four patients who undergo cath lab interventions can benefit from a technology that identifies the
Non-Contrast MRI Effective in Monitoring MS Patients
News | Neuro Imaging | March 18, 2019
Brain magnetic resonance imaging (MRI) without contrast agent is just as effective as the contrast-enhanced approach...
Bay Labs Announces New Data on EchoGPS, AutoEF AI Software at ACC.19
News | Cardiovascular Ultrasound | March 15, 2019
Artificial intelligence (AI) company Bay Labs announced the presentation of two studies assessing performance of the...
CT, Mammograms Offer Clues to Preventing Heart Problems After Cancer Treatment
News | Cardio-oncology | March 13, 2019
An imaging procedure commonly performed before starting cancer treatment can provide valuable clues about a patient's...
Iron Measurements With MRI Reveal Stroke's Impact on Brain

Images show illustrative examples of visual R2? modifications within substantia nigra (SN) at baseline (24-72 h) and follow-up (1 y) in striatum (participants 1 and 2) and control groups (participants 3 and 4). Image courtesy of the Radiological Society of North America (RSNA).

News | Stroke | March 12, 2019
March 12, 2019 — A simple ...
Mississippi Cancer Center Combines RayStation and TomoTherapy for Prostate Cancer Case
News | Treatment Planning | March 08, 2019
Anderson Regional Cancer Center in Meridian, Miss., has treated its first patient using the combination of RaySearch's...
Videos | Proton Therapy | February 28, 2019
ITN Associate Editor Jeff Zagoudis speaks with ...