Stereotactic Radiosurgery and Surgical Resection Offer Similar Local Control of Brain Metastases

PHILADELPHIA (NOVEMBER 8, 2018) – Stereotactic radiosurgery (SRS) offered results comparable to surgery in controlling local brain metastases, Fox Chase Cancer Center researchers have found. The study was produced in collaboration with European Organization for the Research and Treatment of Cancer. It is the largest direct comparison of the two treatment modalities. The paper appears in JAMA Oncology.

Researchers analyzed 268 patients who received either surgery or SRS— focal, high-dose, precisely targeted radiation. They report that early local control of treated lesions was better with SRS compared to those treated surgically, although the relative benefit decreased with time.

“Risk of early local recurrence was higher among surgical patients, while risk of late relapse was higher among SRS patients,” said Stephanie E. Weiss, MD, FASTRO, chief of the Division of Neurological Oncology at Fox Chase, and author of the study. She said that while nine months post-treatment, the risk of recurrence was slightly higher among patients who had received SRS, nevertheless at 2-years, actual local control after SRS remained equal to or better than that of surgery.  

Some of the most commonly diagnosed cancers— lung, breast, colorectal, and melanoma— are also among those most likely to spread to the brain. There are about 140,000 cases of brain metastases annually in the United States. SRS and surgery both have been shown to be more effective at controlling brain metastases than whole-brain radiotherapy, but there was previously little evidence about which option offered the best local control for treating patients with limited brain metastases.

The authors presented an early version of this study at the annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) in September 2017. It was chosen for distinction at the “Scientific Highlights” program, emphasizing high-scoring and high-impact work.

This publication was supported by grant number P30 CA006927 from the National Cancer Institute. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NCI or the National Institutes of Health.

Fox Chase Cancer Center (Fox Chase), which includes the Institute for Cancer Research and the American Oncologic Hospital and is a part of Temple Health, is one of the leading comprehensive cancer centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase is also one of just 10 members of the Alliance of Dedicated Cancer Centers. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence six consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship, and community outreach. It is the policy of Fox Chase Cancer Center that there shall be no exclusion from, or participation in, and no one denied the benefits of, the delivery of quality medical care on the basis of race, ethnicity, religion, sexual orientation, gender, gender identity/expression, disability, age, ancestry, color, national origin, physical ability, level of education, or source of payment.

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