BERKELEY, CA (UroToday.com) - Peter W. Hanson and colleagues at The Gamma Knife of Spokane (Spokane, WA) have recently published a concise review on the efficacy of stereotactic radiosurgery in the management of melanoma and renal cell carcinoma brain metastases. Radioresistant brain metastases, such as metastatic melanoma and renal cell carcinoma, have historically been troublesome to treat. However, stereotactic radiosurgery, a treatment that utilizes a machine such as the Gamma Knife to irradiate small lesions with a high dose of extremely conformal radiation, has emerged as a safe, desirable, and effective minimally-invasive treatment option for many patients suffering from radioresistant brain metastases. The addition of whole-brain radiation therapy to stereotactic radiosurgery in treating these patients is still controversial because of the relative ineffectiveness of whole-brain radiation therapy against radioresistant metastases and its associated side effects. Randomized trials comparing whole-brain radiation therapy alone vs. stereotactic radiosurgery alone vs. whole-brain radiation therapy plus stereotactic radiosurgery in treating patients with radioresistant brain metastases are lacking from the literature, and would help solve this controversy.
The research cited in this review effectively demonstrates that stereotactic radiosurgery is an efficacious and highly appealing treatment option for patients with radioresistant brain metastases. Clinical studies are still ongoing around the world and it is unknown whether specific subgroups of patients will benefit from adding whole-brain radiation therapy to focal Gamma Knife treatment and how this will impact survival rates. The controversy exists because of the known decline in neurocognitive status for patients caused by whole-brain radiation therapy. It is hoped that this review will promote the use of stereotactic radiosurgery as a treatment option for patients with radioresistant brain metastases. The use of whole-brain radiation therapy for all patients with brain metastases should also be further questioned. Peter W. Hanson has stated that “further randomized trials comparing whole-brain radiation therapy alone vs. stereotactic radiosurgery alone vs. whole-brain radiation therapy plus stereotactic radiosurgery must be conducted for patients with radioresistant brain metastases in order to determine the best treatment for these patients.”
Written by:
Christopher M. Lee, MD as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Board Certified Radiation Oncologist
Director of Radiation Research for Cancer Care Northwest
Director of Research for The Gamma Knife of Spokane
Assistant Clinical Professor of Radiation Oncology at the University of Washington
Physician Expert for The Breast Cancer Society
Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, Spokane, WA, 99204, USA
Cancer Care Northwest, 910 W 5th Ave, Suite 102, Spokane, WA, 99204, USA
Gamma Knife of Spokane and Cancer Care Northwest, 601 S. Sherman, Spokane, WA, 99202, USA
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