Skip Navigation


Annals of Oncology Advance Access originally published online on August 5, 2005
Annals of Oncology 2005 16(11):1749-1754; doi:10.1093/annonc/mdi392
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
16/11/1749    most recent
mdi392v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (1)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Gupta, T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gupta, T.
Related Collections
Right arrow 2005 - Review Articles
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 2005 European Society for Medical Oncology

Review

Stereotactic radiosurgery for brain oligometastases: good for some, better for all?

T. Gupta*

Clinical Research Centre, Advanced Centre for Treatment, Research & Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai, India

* Correspondence to: Dr T. Gupta, Clinical Research Centre, Advanced Centre for Treatment, Research & Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai 410208, India. Tel: +91-22-27405057; Fax: +91-22-27412894; E-mail: tejpalgupta{at}rediffmail.com

Brain metastasis is the commonest central nervous system neoplasm affecting 25% patients with cancer. Recursive Partitioning Analysis (RPA) is a reliable prognostic index for patients with brain metastases. In patients with oligometastases and good performance status, decision-making regarding stereotactic radiosurgery (SRS) boost, following whole brain radiation therapy (WBRT), is guided by patient preference, access to radiosurgical facility and institutional policy. Published data for this review was identified by a systematic search of MEDLINE, CANCERLIT and EMBASE databases from 1990 until the present date and was restricted to the English language using appropriate search terms. All three identified randomized controlled trials consistently showed that radiosurgery improves intracranial local control (Level I evidence). Survival benefit, however, is limited to a selected subset of patients (RPA class 1) only. More importantly, patients receiving SRS have significantly better performance scores and decreased steroid requirements resulting in improved health-related quality-of-life (HRQoL). There is no head-to-head comparison of radiosurgery with neurosurgery in resectable single metastasis. SRS is associated with an improvement in outcome. A trial of radiosurgery versus neurosurgery should be attempted to define better the role of SRS in resectable single metastasis. Formal HRQoL assessments should be incorporated as primary end points in future prospective trials.

Key words: brain metastases, HRQoL, stereotactic radiosurgery


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.