"Cancer patients with multiple metastases to the brain face very grim prognoses and limited treatment options," said John Flickinger, M.D., senior author of the study and professor of radiation oncology at the University of Pittsburgh School of Medicine. "In the past, these patients were not considered candidates for radiosurgery. The results of our study indicate that treating four or more brain tumors with radiosurgery is safe and effective and translates into a survival benefit for patients."
Two hundred and five patients with primary malignancies that had metastasized to the brain underwent gamma knife radiosurgery for four or more tumors during one session. Gamma knife is a non-invasive, computer-driven, bloodless brain surgery that uses cobalt 60 to destroy tumors and vascular malformations and requires no surgical incisions. The average number of brain tumors for patients in the study was five, with a range from four to 18. Radiosurgery was used alone, in combination with whole brain radiation or after failure of whole brain radiation.
Radiosurgery patients with the most prognostic factors associated with survival from brain metastases (defined as class 1 according to the Radiation Therapy Oncology Group classification system for patients with brain metastases) survived an average of 18 months, compared to a reported historical average of seven months for those who received whole brain radiation alone. Patients defined as class 2 who received radiosurgery survived nine months compared to the historical average survival of four months for patients who received whole brain radiation. P