Date post: | 19-Jan-2018 |
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POST-OPERATIVE STEREOTACTIC RADIOSURGERY TO THE RESECTION CAVITY
FOR LARGE BRAIN METASTASES
Poster # 1084
Ling DC, Vargo JA, Wegner RE, Flickinger JC, Burton S, Engh J, Amankulor N, Quinn AE, Ozhasoglu C, Heron DE
METHODS
• Median dose was 22Gy (range: 1000-2800) in 1 to 5 fractions
• Median treatment volume was 12.6 cc (range: 0.6-51.1).
Assessed for eligibility (n=108)• Large brain metastasis (>3 cm
on pre-operative MRI)• Index lesion treated with
resection followed by SRS• Biopsy-proven systemic cancer
Excluded (n=6)• Patients treated with
SRS >3 months after resection (n=6)
102 patients with 103 large brain metastases analyzed
87 patients (88 metastases) with follow-up imaging included in LC
and DBF analysis
102 patients included in OS analysis
RESULTSRisk Stratification for Freedom from Distant Brain Failure. (A) Systemic Disease Control, (B) Non-melanoma primary (C) Number of Brain Metastases (D) Combined Risk Stratification.
CONCLUSIONS• Postoperative SRS to the resection cavity following
craniotomy is a safe & effective local treatment for large brain metastases independent of extent of resection, size of resection cavity, histology, number of metastases or systemic disease control.
• Patients with controlled systemic disease and ≤ 3
brain metastases are ideal candidates for postoperative SRS with significantly lower rates of DBF.