Study Finds SRS Provides Comparable Control of Brain Metastases to That of Surgery

An analysis led by researchers at Fox Chase Cancer Center in Philadelphia, in collaboration with the European Organization for the Research and Treatment of Cancer, found that treating cancer that has metastasized to the brain with focal, high-dose radiation yields improved early results compared with surgical removal. Patients who underwent stereotactic radiosurgery (SRS), a type of precisely targeted radiation therapy, had a lower chance of recurrence of brain metastases for the first several months after treatment, compared with those whose lesions were surgically removed. The advantage of SRS, however, diminished over time, and, beginning nine months posttreatment, control favored surgery.

Thomas Churilla, MD, a senior radiation oncology resident at Fox Chase, led the study and presented it at an oral session at the annual ASTRO meeting in San Diego on September 27. It was chosen for distinction at the "Scientific Highlights" program, which emphasizes high-scoring and high-impact work.

Some of the most commonly diagnosed cancers—lung, breast, colorectal, and melanoma—are also among those most likely to spread to the brain. Earlier research has demonstrated that both surgery and radiosurgery provide better local control and, in select patients, a survival benefit, compared with whole-brain radiotherapy alone. More recently, investigators have examined using surgery or SRS alone for brain metastases and deferring whole-brain radiation in order to reduce treatment-related toxicity. However, no robust head-to-head comparison between these two focal modalities has ever been successfully conducted.

"Our analysis shows that, for most patients, stereotactic radiosurgery provides control of metastatic brain lesions comparable to surgical removal in a noninvasive fashion. To our knowledge, this is the highest quality and largest data set comparing these two modalities," Churilla says.

Last year, Churilla won ASTRO's 2016 Clinical Science Research Abstract Award, which recognizes the top research presented by medical residents.

Source: Fox Chase Cancer Center