International Journal of Radiation Oncology * Biology * Physics
Volume 53, Issue 3 , Pages 519-526 , 1 July 2002

A multi-institutional review of radiosurgery alone vs. radiosurgery with whole brain radiotherapy as the initial management of brain metastases

  • Penny K Sneed, M.D.

      Affiliations

    • Corresponding Author InformationReprint requests to: Penny K. Sneed, M.D., Dept. of Radiation Oncology, Room L-08 (Box 0226), University of California, 505 Parnassus Avenue, San Francisco, CA 94143-0226 USA. Tel: (415) 353-8900; Fax: (415) 353-8679
    • Department of Radiation Oncology, University of California, San Francisco, CA, USA
    • ,
  • John H Suh, M.D.

      Affiliations

    • Department of Radiation Oncology, Cleveland Clinic Foundation, Cleveland, OH, USA
    • ,
  • Steven J Goetsch, Ph.D.

      Affiliations

    • San Diego Gamma Knife Center, San Diego, CA, USA
    • ,
  • Seema N Sanghavi, M.D.

      Affiliations

    • Department of Human Oncology, University of Wisconsin, Madison, WI, USA
    • ,
  • Richard Chappell, Ph.D.

      Affiliations

    • Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, WI, USA
    • ,
  • John M Buatti, M.D.

      Affiliations

    • Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
    • ,
  • William F Regine, M.D.

      Affiliations

    • Department of Radiation Medicine, University of Kentucky, Lexington, KY, USA
    • ,
  • Eduardo Weltman, M.D.

      Affiliations

    • Department of Radiation Oncology, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
    • ,
  • Vernon J King, M.D.

      Affiliations

    • Department of Radiation Oncology, Albany Medical Center, Albany, NY, USA
    • ,
  • John C Breneman, M.D.

      Affiliations

    • Department of Radiology, University of Cincinnati, Cincinnati, OH, USA
    • ,
  • Paul W Sperduto, M.D.

      Affiliations

    • Department of Radiation Oncology, Methodist Hospital Cancer Center, Minneapolis, MN, USA
    • ,
  • Minesh P Mehta, M.D.

      Affiliations

    • Department of Human Oncology, University of Wisconsin, Madison, WI, USA

Received 5 March 2001 ,Accepted 11 February 2002.

References 

  1. Hojo S, Hirano A. Pathology of metastases affecting the central nervous system. In:  Takakura K,  Sano K,  Hojo S, et al. editor. Metastatic tumors of the central nervous system. Tokyo: Igaku-Shoin; 1982;p. 5–35
  2. Posner JB, Chernik NL. Intracranial metastases from systemic cancer. Adv Neurol. 1978;19:579–592
  3. Borgelt B, Gelber R, Kramer S, et al.  The palliation of brain metastases (Final results of the first two studies by the Radiation Therapy Oncology Group). Int J Radiat Oncol Biol Phys. 1980;6:1–8
  4. Kondziolka D, Patel A, Lunsford LD, et al.  Stereotactic radiosurgery plus whole brain radiotherapy versus radiotherapy alone for patients with multiple brain metastases. Int J Radiat Oncol Biol Phys. 1999;45:427–434
  5. Patchell RA, Tibbs PA, Walsh JW, et al.  A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med. 1990;322:494–500
  6. Asai A, Matsutani M, Kohno T, et al.  Subacute brain atrophy after radiation therapy for malignant brain tumor. Cancer. 1989;63:1962–1974
  7. DeAngelis LM, Delattre JY, Posner JB. Radiation-induced dementia in patients cured of brain metastases. Neurology. 1989;39:789–796
  8. Chidel MA, Suh JH, Reddy CA, et al.  Application of recursive partitioning analysis and evaluation of the use of whole brain radiation among patients treated with stereotactic radiosurgery for newly diagnosed brain metastases. Int J Radiat Oncol Biol Phys. 2000;47:993–999
  9. Sneed PK, Lamborn KR, Forstner JM, et al.  Radiosurgery for brain metastases (Is whole brain radiotherapy necessary?). Int J Radiat Oncol Biol Phys. 1999;43:549–558
  10. Joseph J, Adler JR, Cox RS, et al.  Linear accelerator-based stereotaxic radiosurgery for brain metastases (The influence of number of lesions on survival). J Clin Oncol. 1996;14:1085–1092
  11. Pirzkall A, Debus J, Lohr F, et al.  Radiosurgery alone or in combination with whole-brain radiotherapy for brain metastases. J Clin Oncol. 1998;16:3563–3569
  12. Sanghavi SN, Miranpuri SS, Chappell R; et al. Radiosurgery for patients with brain metastases: A multi-institutional analysis, stratified by the RTOG recursive partitioning analysis methodology. Submitted.
  13. Kooy HM. Linear accelerators in stereotactic radiosurgery. In:  Alexander E,  Loeffler JS,  Lunsford LD editor. Stereotactic radiosurgery. New York: McGraw-Hill, Inc; 1993;p. 67–76
  14. Lindquist C. Gamma knife radiosurgery. Semin Radiat Oncol. 1995;5:197–202
  15. Wu A, Lindner G, Maitz AH, et al.  Physics of gamma knife approach on convergent beams in stereotactic radiosurgery. Int J Radiat Oncol Biol Phys. 1990;18:941–949
  16. Cox DR. Regression models and life tables. J R Stat Soc. 1972;34:187–220
  17. Radiation Therapy Oncology Group (RTOG) Gaspar L, Scott C, Rotman M, et al.  Recursive partitioning analysis (RPA) of prognostic factors in three   brain metastases trials. Int J Radiat Oncol Biol Phys. 1997;37:745–751

PII: S0360-3016(02)02770-0

International Journal of Radiation Oncology * Biology * Physics
Volume 53, Issue 3 , Pages 519-526 , 1 July 2002

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