Comparing pre-operative versus post-operative single and multi-fraction stereotactic radiotherapy for patients with resectable brain metastases

• DOI: 10.1016/j.ctro.2022.11.004
• Publication Date: 2022-11-09T08:07:37Z
• Authors: Haley K. Perlow; Cindy Ho; Jennifer K. Matsui; Rahul N. Prasad; Brett G. Klamer; Joshua Wang; Mark Damante; Rituraj Upadhyay; Evan Thomas; Dukagjin M. Blakaj; Sasha Beyer; Russell Lonser; Douglas Hardesty; Raju R. Raval; Roshan Prabhu; James B. Elder; Joshua D. Palmer
• Keywords: Clinical endpoint

The standard treatment for patients with large brain metastases and limited intracranial disease is surgical resection post-operative stereotactic radiosurgery (SRS). However, SRS still has elevated rates of local failure (LF) complicated by radiation necrosis (RN), meningeal (MD). Pre-operative may reduce the risk RN MD, while fractionated therapy improve control through delivering a higher biological effective dose. We hypothesize that pre-operative (FSRT) will have less toxicity compared to who receive or FSRT.A multi-institutional analysis was conducted included had treat at least one metastasis. Pertinent demographic, clinical, radiation, surgical, follow up data were collected each patient. primary outcome composite endpoint defined as following adverse events: 1) LF, 2) and/or 3) Grade 2 (symptomatic) RN.279 eligible analysis. median follow-up time 9 months. 87 % received treatment. 29 incidences (n = 10), FSRT 189), 27), 53) 0 %, 17 15 7.5 respectively.In our study, 7.5% compares favorably rate 17%. observed low RN. Prospective validation needed.