Contemporary practice patterns of stereotactic radiosurgery for brain metastasis: A review of published Australian literature.
Wee Loon OngMorikatsu WadaJeremy RubenFarshad ForoudiJeremy MillarPublished in: Journal of medical imaging and radiation oncology (2019)
There has been a shift in the management of brain metastasis (BM), with increasing use of stereotactic radiosurgery (SRS) and delaying/avoiding whole-brain radiotherapy (WBRT), given the concern regarding the long-term neurocognitive effect and quality of life impact of WBRT. It is, however, unclear as to the contemporary practice pattern and outcomes of SRS in Australia. We conducted a literature search in PubMed and MEDLINE using a series of keywords: 'stereotactic', 'radiosurgery' and 'brain metastases', limiting to Australian studies, which report on clinical outcomes following SRS. Eight studies - one randomized trial and seven retrospective cohort studies - were identified and included in this review. A total of 856 patients were included, with the most common primary tumour types being melanoma, lung cancer and breast cancer. Approximately half of the patients had solitary BM, while 7% had 10 or more BM lesions. SRS is not routinely given in combination with WBRT. The 6-month intracranial control and 1-year intracranial control following SRS were reported in the range of 67-87% and 48-82%, respectively, whereas the 1-year overall survival and 2-year overall survival were reported in the range of 37-60% and 20-36%, respectively. There are limited data reported on SRS-related toxicities in all included studies. Overall, despite increasing use of SRS for BM, there is a low number of published Australian series in the literature. There is a potential role for establishing an Australian clinical quality registry or collaborative consortium for SRS in BM, to allow for systematic prospective data collection, and benchmarking of quality and outcomes of SRS.
Keyphrases
- brain metastases
- end stage renal disease
- systematic review
- small cell lung cancer
- newly diagnosed
- ejection fraction
- healthcare
- chronic kidney disease
- white matter
- resting state
- quality improvement
- primary care
- peritoneal dialysis
- prognostic factors
- radiation therapy
- functional connectivity
- big data
- bipolar disorder
- randomized controlled trial
- patient reported outcomes
- young adults
- blood brain barrier
- brain injury
- cerebral ischemia
- skeletal muscle
- radiation induced
- skin cancer