[Metastatic brain lesion paradigm shift in radiation therapy].

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[Metastatic brain lesion paradigm shift in radiation therapy].

Vopr Onkol. 2015;61(4):530-45

Authors: Golanov AV, Banov SM, Vetlova ER

Abstract
The development of methods of treatment using radiosurgery devices “Gamma Knife”, “Cyber Knife” has significantly changed the results of treatment of patients with brain metastases, which allowed formulating new principles of treatment of this group of patients. Radiosurgical treatment by means of “Gamma Knife” and “Cyber Knife” provides stable reproducible results with local tumor control in the case of both single and multiple lesions. The optimal minimum dose is 18Gy. Indicators of local control were 90-94% for brain metastases from breast cancer and 81-98% for brain metastases from lung cancer. With respect to radioresistant brain metastases local tumor control after radiosurgical treatment was 73-90% for patients with melanoma and 83%-96% for patients with renal cell carcinoma. Currently there is a tendency of application of radiosurgical treatment of patients with multiple brain mertastases. Numerous studies show a high rate of local tumor control after radiosurgical treatment in this patient group. This review summarizes current literature data on radiosurgical treatment for brain metastases with an emphasis on survival, local control, distant metastasis, quality of life as well as the potential combinations of existing treatment methods.

PMID: 26571820 [PubMed – in process]