Neuro-oncology advances · 2026
How safe and effective is radiosurgical treatment for patients with 10 or more brain metastases?
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Cho Anna, Jankowski Thore, Chen Yiru, Kohlmaier Lukas, Gatterbauer Brigitte, Lederer Philip, Haider Lukas, Tögl Sonja, Rössler Karl, Dorfer Christian, Dodier Philippe, Höller Christoph, Bartsch Rupert, Hochmair Maximilian J, Frischer Josa M
Аннотация
BACKGROUND: We evaluated the outcome of radiosurgically treated patients with ≥10 brain metastases (BM), compared to patients <10 BM.
METHODS: Patients, who underwent at least one Gamma Knife radiosurgical (GKRS) treatment for at least one BM without previous Central Nervous System (CNS) treatments, were retrospectively divided into 2 groups: (1) < 10 or (2) ≥ 10 BM.
RESULTS: At GKRS1, 1293 patients had <10 BM and 126 patients had ≥10 BM. The estimated median survival after GKRS1 was significantly longer in patients with <10 BM (9.9 months), compared to patients with ≥10 BM at GKRS1 (5.3 months; P < .001). Age >65 years (P < .001), male sex (P = .001), Karnofsky Performance Status Scale <80 (P < .001), presence of extracranial metastases (P = .008), presence of neurological symptoms (P = .019), a cumulative BM volume of all BM treated at GKRS1 ≥ 10 cm3 (P = .017), no concomitant immunotherapy or targeted therapy at GKRS1 (P < .001), and the number of ≥10 BM at GKRS1 (P < .001) were identified as independent prognostic factors for an increased risk of death. In patients with ≥10 BM, poor clinical condition, a cumulative BM volume of all BM treated ≥25 cm3, and no concomitant immunotherapy or targeted therapy at GKRS1 were identified as significant independent prognostic factors. The occurrence of post-radiosurgical complications and local tumor control did not differ between the groups.
CONCLUSIONS: In addition to BM count, multiple factors may influence survival and should be considered during the pre-radiosurgery assessment. GKRS represents a safe and effective first-line treatment method even for patients with ≥10 BM, particularly in the era of modern systemic therapies.
METHODS: Patients, who underwent at least one Gamma Knife radiosurgical (GKRS) treatment for at least one BM without previous Central Nervous System (CNS) treatments, were retrospectively divided into 2 groups: (1) < 10 or (2) ≥ 10 BM.
RESULTS: At GKRS1, 1293 patients had <10 BM and 126 patients had ≥10 BM. The estimated median survival after GKRS1 was significantly longer in patients with <10 BM (9.9 months), compared to patients with ≥10 BM at GKRS1 (5.3 months; P < .001). Age >65 years (P < .001), male sex (P = .001), Karnofsky Performance Status Scale <80 (P < .001), presence of extracranial metastases (P = .008), presence of neurological symptoms (P = .019), a cumulative BM volume of all BM treated at GKRS1 ≥ 10 cm3 (P = .017), no concomitant immunotherapy or targeted therapy at GKRS1 (P < .001), and the number of ≥10 BM at GKRS1 (P < .001) were identified as independent prognostic factors for an increased risk of death. In patients with ≥10 BM, poor clinical condition, a cumulative BM volume of all BM treated ≥25 cm3, and no concomitant immunotherapy or targeted therapy at GKRS1 were identified as significant independent prognostic factors. The occurrence of post-radiosurgical complications and local tumor control did not differ between the groups.
CONCLUSIONS: In addition to BM count, multiple factors may influence survival and should be considered during the pre-radiosurgery assessment. GKRS represents a safe and effective first-line treatment method even for patients with ≥10 BM, particularly in the era of modern systemic therapies.