Study: Preoperative stereotactic radiosurgery shows promise in brain metastases management

Editor's Note

A new international study reports low rates of local recurrence, radionecrosis, and leptomeningeal disease in patients receiving neoadjuvant stereotactic radiosurgery (SRS) before brain metastases resection, Medscape Medical News reported January 6.

Published in Radiotherapy and Oncology, the analysis included 179 patients with 189 brain metastases treated at nine institutions across five countries. Patients underwent either single-fraction (53%) or multi-fraction (47%) SRS before surgery, Medscape reports. The study observed a composite endpoint of local recurrence, any grade radionecrosis, and nodular leptomeningeal disease, alongside assessments of distant brain failure and overall survival.

At 12 months, the incidence for the composite endpoint was 8.0%, rising to 12.3% at 24 months. Local recurrence occurred in 6.3% of metastases, while any grade radionecrosis was observed in 5.3%, with 2.6% of patients developing symptomatic radionecrosis. Leptomeningeal disease was noted in 9.5% of patients, with a 24-month incidence of 11.0%. Distant brain failure occurred in 29.1% of patients, and overall survival rates were 66.3% at 12 months and 48.2% at 24 months.