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Schöggl, A; Kitz, K; Reddy, M; Wolfsberger, S; Schneider, B; Dieckmann, K; Ungersböck, K.
Defining the role of stereotactic radiosurgery versus microsurgery in the treatment of single brain metastases.
Acta Neurochir (Wien). 2000; 142(6):621-6 Doi: 10.1007/s007010070104
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Co-authors Med Uni Graz
Wolfsberger Stefan
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Abstract:
Stereotactic radiosurgery (RS) and surgery have proved to be effective treatment modalities for brain metastasis. We followed 133 patients whose treatment for intracranial disease was either RS or a single surgical resection at the University of Vienna from August 1992 through October 1996. All patients who received additional Whole Brain Radiotherapy were included. This was a retrospective, case-control study comparing these treatment modalities. Sixty-seven patients were treated by RS and 66 patients were treated by microsurgery. The median size of the treated lesions for RS patients was 7800 mm3, and 12500 mm3 for microsurgery patients, respectively. The median dose delivered to the tumour margin for RS patients was 17 gray. The median survival for patients after RS was 12 months, and 9 months for patients after microsurgery. This difference was not statistically significant (p = 0.19). Comparison of local tumour control, defined as absence of regrowth of a treated lesion, showed that tumours following RS had a preferred local control rate (p < 0.05). Univariate and multivariate analysis showed that this fact was due to a greater response rate of "radioresistant" metastasis to RS (p < 0.005). Postradiosurgical complications included the onset of peritumoural oedema (n = 5) and radiation necrosis (n = 1). Two patients after microsurgery experienced local wound infection. One postoperative death occurred due to pulmonary embolism in this group. On the basis of our data we conclude that RS and microsurgery combined with Whole Brain Radiotherapy are comparable modalities in treating single brain metastasis. Concerning morbidity and local tumour control, in particular in cases of "radioresistant" primary tumours, RS is superior. Therefore we advocate RS except for cases of large tumours (> 3 cm in maximum diameter) and for those with mass effect.
Find related publications in this database (using NLM MeSH Indexing)
Brain Neoplasms - secondary, surgery
Female - administration & dosage
Humans - administration & dosage
Male - administration & dosage
Microsurgery - administration & dosage
Middle Aged - administration & dosage
Postoperative Complications - administration & dosage
Radiosurgery - administration & dosage
Stereotaxic Techniques - administration & dosage
Survival Analysis - administration & dosage

Find related publications in this database (Keywords)
brain metastasis
stereotactic radiosurgery
surgery
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