Effectiveness of Postoperative Gamma Knife Radiosurgery to the Tumor Bed After Resection of Brain XXXX .

@entity5 @entity1 @entity3
OBJECTIVE: The role of Gamma knife radiosurgery (GKS) after the resection of brain metastases remains undefined. We evaluated the outcomes of postoperative GKS to the @entity5 bed after the resection of brain @entity3 compared with GKS alone without resection in the same @entity1 . METHODS: We performed a retrospective review of 24 @entity1 who underwent GKS to the @entity5 bed after the resection of brain metastases. In this cohort, 25 metastatic lesions were treated with postoperative GKS, and 37 brain metastatic lesions were simultaneously managed with GKS alone without resection. RESULTS: The median target volume and marginal dose of GKS to the surgical bed were 10.5 cm(3) and 15.0 Gy, respectively. The median target volume and marginal dose of GKS alone for the metastatic lesions were 0.5 cm(3) and 21.0 Gy, respectively. The actuarial 1-year and 2-year overall survival of the @entity1 were 43.1% and 28.7%, respectively. The median overall survival of all @entity1 was 11 months. The actuarial 6-month and 12-month local progression-free survival of GKS alone for metastatic lesions without resection were 92.6% and 84.9%; however, the actuarial 6-month and 12-month local progression-free survival of GKS to the surgical bed were 82% and 71%, respectively. CONCLUSIONS: For @entity1 with brain metastases treated with surgical resection, postoperative GKS to the resection area is an effective and safe treatment option. Particularly, concurrent postoperative GKS to the surgical cavity with GKS alone for multiple small metastatic lesions is a feasible treatment strategy for multiple brain metastases.
