Effect of Postoperative Radiotherapy for Brain Metastases: An Analysis.
INTRODUCTION
Brain metastases (BM) have a very poor prognosis, creating a demand for effective local therapies, such as radiotherapy (RT) and neurosurgery, the combination of which is debatable. The aim of the present study was to investigate prognostic factors and to develop treatment recommendations for patients with BM.


MATERIAL AND METHODS
A total of 84 patients treated between May 2011 and July 2016 were analyzed in a single-institution retrospective study.


RESULTS
Overall survival (OS) was 10.3 months. Poor OS was defined by a Karnofsky performance index of ≤70% (2.9 vs. 15.8 months; p = 0.009), male gender (6.5 vs. 18.3 months; p = 0.044), and incomplete neurosurgical resection (2.5 vs. 15.8 months; p = 0.017). These factors were also shown to be significant in univariate analysis, while only radical resection remained significant in multivariate testing (p = 0.023). A direct comparison between whole-brain RT (with or without boost) and local RT illustrated a superior OS for local therapy (22.7 vs. 9.5 months; p = 0.022), especially in case of up to 3 metastases (p = 0.041). Intracranial control was 81% with a median duration of 31.6 months.


CONCLUSION
Combined modality treatment of RT and neurosurgery is effective and feasible. A complete removal of all metastases is the cardinal prognostic factor.
['Oertel|Michael|M|', 'Baehr|Andrea|A|', 'Habibeh|Omar|O|', 'Haverkamp|Uwe|U|', 'Stummer|Walter|W|', 'Eich|Hans Theodor|HT|', 'Trog|Daniela|D|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D001932:Brain Neoplasms D016371:Cranial Irradiation D005260:Female D006801:Humans D017567:Karnofsky Performance Status D008297:Male D008875:Middle Aged D011379:Prognosis D018714:Radiotherapy, Adjuvant D012189:Retrospective Studies D055815:Young Adult
Postoperative radiotherapy Brain metastases Neurosurgery Whole-brain radiotherapy