POST-OPERATIVE STEREOTACTIC RADIOSURGERY TO THE RESECTION CAVITY

FOR LARGE BRAIN METASTASES

Poster # 1084

Ling DC, Vargo JA, Wegner RE, Flickinger JC, Burton S, Engh J, Amankulor N, Quinn AE, Ozhasoglu C, Heron DE

METHODS

• Median dose was 22Gy (range: 1000-2800) in 1 to 5 fractions

• Median treatment volume was 12.6 cc (range: 0.6-51.1).

Assessed for eligibility (n=108)• Large brain metastasis (>3 cm

on pre-operative MRI)• Index lesion treated with

resection followed by SRS• Biopsy-proven systemic cancer

Excluded (n=6)• Patients treated with

SRS >3 months after resection (n=6)

102 patients with 103 large brain metastases analyzed

87 patients (88 metastases) with follow-up imaging included in LC

and DBF analysis

102 patients included in OS analysis

RESULTSRisk Stratification for Freedom from Distant Brain Failure. (A) Systemic Disease Control, (B) Non-melanoma primary (C) Number of Brain Metastases (D) Combined Risk Stratification.

CONCLUSIONS• Postoperative SRS to the resection cavity following

craniotomy is a safe & effective local treatment for large brain metastases independent of extent of resection, size of resection cavity, histology, number of metastases or systemic disease control.

• Patients with controlled systemic disease and ≤ 3

brain metastases are ideal candidates for postoperative SRS with significantly lower rates of DBF.