Preoperative Stereotactic Radiosurgery for Brain Metastases: A Single-Institution Experience
Turkish Neurosurgery, cilt.35, sa.3, ss.474-483, 2025 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 35 Sayı: 3
- Basım Tarihi: 2025
- Doi Numarası: 10.5137/1019-5149.jtn.45236-23.2
- Dergi Adı: Turkish Neurosurgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, MEDLINE, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.474-483
- Anahtar Kelimeler: Preoperative, Brain metastasis, Stereotactic radiotherapy, Preoperative, Brain metastasis, Stereotactic radiotherapy
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
AIM: To report a single center experience in preoperative stereotactic radiosurgery (SRS) in patients with metastatic brain tumors. MATERIAL and METHODS: We identified 18 patients who underwent preoperative stereotactic radiosurgery (SRS) in our clinic between 2015 and 2021. Two patients were lost to follow-up and therefore were excluded from clinical outcome analyses. SRS was administered using the CyberKnife system. RESULTS: The median volume of index lesion was 14,19 mL (range 3,13-40,84). SRS was performed in median 1 fraction (range 1–2) to a median prescription dose of 15 Gy (range 12–17). Gross total resection was achieved in 14 (77.8%) patients. The median follow-up was 15 months (range 1–87). Median cancer specific survival (CSS) was 31 months. 6-, 12- and 24- months local control (LC) rates were 91%, 79% and 68%, respectively. Better gross tumor volume coverage was associated with better LC (p=0.01). 6-, 12- and 24- months distant brain control (DBC) rates were 82%, 58% and 47%, respectively. The infratentorial location of index lesion was associated with worse DBC (p=0.026). None of the failures were in the pattern of leptomeningeal dissemination (LMD). Grade IV symptomatic radionecrosis (RN) was reported in a single case. Three patients experienced fatal (grade V) post-operative complications. CONCLUSION: Preoperative SRS approach, which provides the advantage of low rates of RN and LMD, is a meritorious alternative strategy in the treatment of brain metastasis. Care must be given to better assessment of surgical mortality and the selection of appropriate patients for this treatment approach.