Stereotactic radiosurgery for patients with 10 or more brain metastases

Masaaki Yamamoto, Yoshinori Higuchi, Yasunori Sato, Hidetoshi Aiyama, Hidetoshi Kasuya, Bierta E. Barfod

Research output: Contribution to journalArticle

Abstract

The JLGK0901 study showed the non-inferiority of stereotactic radiosurgery (SRS) alone as the initial treatment for 5-10 as compared to 2-4 brain metastases (BM) in terms of overall survival and most secondary endpoints [Lancet Oncol 2014;15:387-395]. A trend for patients with 5-10 tumors to undergo SRS alone has since become apparent. The next step is to reappraise whether results of SRS treatment alone for tumor numbers ≥10 differ from those for 2-9 tumors. During the past 2 decades, several retrospective studies have demonstrated the SRS alone treatment strategy to have certain benefits for carefully selected patients with ≥10 BM, i.e., a sufficiently long survival period with lower incidences of neurological death, neurological deterioration, local recurrence, and SRS-related complications. Herein, we introduce our Mito experiences with SRS for ≥10 BM, employing a case-matched study on 934 patients, 467 each in groups with 2-9 BM and ≥10 BM. Post-SRS treatment results, i.e., median survival time, neurological death-free survival time and cumulative incidences of local recurrence, repeat SRS for new lesions, neurological deterioration, and SRS-related complications, were not inferior for patients with ≥10 BM as compared to those with 2-9 BM. We conclude that patients with ≥10 tumors are not unfavorable candidates for SRS alone.

Original languageEnglish
Pages (from-to)110-124
Number of pages15
JournalProgress in Neurological Surgery
Volume34
DOIs
Publication statusPublished - 2019 Jan 1
Externally publishedYes

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Radiosurgery
Neoplasm Metastasis
Brain
Survival
Neoplasms
Recurrence
Incidence
Therapeutics
Retrospective Studies

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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Stereotactic radiosurgery for patients with 10 or more brain metastases. / Yamamoto, Masaaki; Higuchi, Yoshinori; Sato, Yasunori; Aiyama, Hidetoshi; Kasuya, Hidetoshi; Barfod, Bierta E.

In: Progress in Neurological Surgery, Vol. 34, 01.01.2019, p. 110-124.

Research output: Contribution to journalArticle

Yamamoto, Masaaki ; Higuchi, Yoshinori ; Sato, Yasunori ; Aiyama, Hidetoshi ; Kasuya, Hidetoshi ; Barfod, Bierta E. / Stereotactic radiosurgery for patients with 10 or more brain metastases. In: Progress in Neurological Surgery. 2019 ; Vol. 34. pp. 110-124.
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