Better outcomes observed with targeted radiosurgery versus whole-brain radiation in metastatic brain tumors
A recent study conducted by scientists at the University of Missouri School of Medicine (MO, USA) looked at two common postsurgical metastatic brain tumor therapies side by side and demonstrated better outcomes with stereotactic radiosurgery (SRS) than whole-brain radiation therapy (WBRT).
The American Brain Tumor Association refers to metastatic brain tumors as, the most common brain tumor in adults; figures estimate this type of tumor affects between 200,000 and 300,000 individuals annually.
WBRT treats the whole brain and therapy is therefore thought to control tumor spread by treating cancerous cells that are both seen and unseen. The negative side to WBRT is that it has been linked to cognitive function decline and can therefore result in a lower quality of life. Conversely, SRS is a targeted therapy, delivering radiation doses to more specific areas of the brain. A patient undergoing SRS experiences less cognitive decline, as there is less unintentional damage to surrounding healthy brain tissue.
According to authors of this study, published recently in the journal Cureus, there is not enough data evaluating how effective postoperative WBRT is compared with postoperative SRS in terms of tumor control and survival outcomes.
N Scott Litofsky (University of Missouri School of Medicine), senior author of the study explained, “Although radiosurgery has been shown to be an effective postsurgical treatment for metastatic brain tumors, previous studies did not compare patient outcomes from a single hospital over the same period of time.”
Describing the value of this study Litofsky stated, “Our study is one of the first to directly compare outcomes of patients treated at the same hospital during a set period of time. Ultimately, our findings reinforce the use of radiosurgery over whole-brain radiation.”
Patients with ‘surgical resection of single-brain metastases’ from January 2010 to December 2014 were treated – 46 patients received postoperative WBRT and 37 received postoperative tumor bed SRS. Among many outcomes described in the paper, 34% of SRS patients experienced local recurrence versus 53% of WBRT patients, with median survival being 440 and 202 days, respectively.
Litofsky goes on to explain that, “For patients with metastatic cancer of the brain, the importance of surviving for a longer period of time cannot be overstated.” He continued, “In our practice, we now treat patients almost exclusively with radiosurgery following their surgery. Although this therapy does cost more, results often can be achieved in one to three visits compared to 10 to 12 visits for whole-brain radiation. With these considerations, we strongly suggest physicians consider radiosurgery as an initial radiation treatment after surgery.”
Sources: Scheitler-Ring K, Ge B, Petroski G, Biedermann G, Litofsky NS. Radiosurgery to the postoperative tumor bed for metastatic carcinoma versus whole brain radiation after surgery. Cureus 8(11), e885 (2016); University of Missouri School of Medicine news release; American Brain Tumor Association
