Modern management for brain metastasis patients using stereotactic radiosurgery: literature review and the authors’ gamma knife treatment experiences

Abstract

Yoshinori Higuchi,1,* Masaaki Yamamoto,2,* Toru Serizawa,3 Hitoshi Aiyama,2 Yasunori Sato,4 Bierta E Barfod2 1Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Japan; 2Katsuta Hospital Mito Gamma House, Hitachi-Naka, Japan; 3Tokyo Gamma Unit Center, Tsukiji Neurological Clinic, Tokyo, Japan; 4Department of Global Clinical Research, Chiba University Graduate School of Medicine, Chiba, Japan *These authors contributed equally to this work Abstract: Historically, whole brain radiotherapy was administered to most patients with brain metastases. However, over the past three decades, stereotactic radiosurgery (SRS), targeted at individual cranial lesions, has been accepted widely. In this study, based on the authors’ experiences along with published data, recent trends in SRS for brain metastases are discussed. This article focuses on the following issues: 1) How many tumors can or should be treated with SRS? 2) Two-/three-staged SRS for relatively large tumors, 3) post- or preoperative SRS, and 4) repeat SRS. Keywords: brain metastases, radiotherapy, radiosurgery, gamma knife

Keywords

• brain metastases
• radiotherapy
• radiosurgery
• gamma knife