Stereotactic Radiosurgery to the Resection Cavity Following Surgical Removal of Brain Metastasis

Brain metastases (BM) are the most common intracranial tumors in adults and source of the most common neurological complications of systemic cancer. Surgery and radiation therapy are the most important components in the management of BM with the goal to prolong survival and improve the quality of life. Whole brain radiotherapy (WBRT) has shown to increase local and distant control both with and without surgical resection. However, patients who develop a new or recurrent BM after WBRT and undergo resection are left without adjuvant therapy options. Local recurrence particular in patients with single metastasis does effect both survival and quality of life. In individual cases the option of additional radiotherapy has been suggested and applied. We seek to evaluate the addition of a stereotactic radiosurgery (SRS) boost to the resection cavity both as adjuvant and salvage procedure among patients, who undergo resection of a BM and previously received WBRT or decline WBRT. Goal is to show superior local brain control.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* Patient must have undergone surgical resection of a brain metastasis
* Patients with no more than 3 brain metastases on contrast MRI.
* Previous WBRT for brain malignancy, except patients with melanoma, renal cell carcinoma.
* Adult patient aged \> 18.
* Patient must be in adequate general health, as indicated by:

  * Karnofsky performance status equal or greater than 60.
  * The absence of a concomitant life-threatening disease other than the malignancy.
* Patient must understand the investigational nature of this study and sign informed consent form, approved by the Institutional Review Board.

Exclusion Criteria:

* Pregnancy
* Patients unable or unwilling to follow protocol requirements