The authors declare no competing financial interests.
PWH, ALE and CML reviewed relevant literature for this review and drafted the manuscript. WTL, JJD, RFK, ARM, BSC and SRT provided expertise relevant to this review and helped draft the manuscript. All authors read and approved the final manuscript.
Melanoma and renal cell carcinoma have a well-documented tendency to develop metastases to the brain. Treating these lesions has traditionally been problematic, because chemotherapy has difficulty crossing the blood brain barrier and whole brain radiation therapy (WBRT) is a relatively ineffective treatment against these radioresistant tumor histologies. In recent years, stereotactic radiosurgery (SRS) has emerged as an effective and minimally-invasive treatment modality for irradiating either single or multiple intracranial structures in one clinical treatment setting. For this reason, we conducted a review of modern literature analyzing the efficacy of SRS in the management of patients with melanoma and renal cell carcinoma brain metastases. In our analysis we found SRS to be a safe, effective and attractive treatment modality for managing radioresistant brain metastases and highlighted the need for randomized trials comparing WBRT alone vs. SRS alone vs. WBRT plus SRS in treating patients with radioresistant brain metastases.
Posner JB: Management of brain metastases. Rev Neurol (Paris). 1992, 148: 477-487.
Manon R, O’Neill A, Knisely J, Werner-Wasik M, Lazarus HM, Wagner H, Gilbert M, Mehta M: Phase II trial of radiosurgery for one to three newly diagnosed brain metastases from renal cell carcinoma, melanoma, and sarcoma: an Eastern Cooperative Oncology Group study (E 6397). J Clin Oncol. 2005, 23: 8870-8876. 10.1200/JCO.2005.01.8747. CrossRefPubMed
Barth A, Wanek LA, Morton DL: Prognostic factors in 1,521 melanoma patients with distant metastases. J Am Coll Surg. 1995, 181: 193-201. PubMed
Lavine SD, Petrovich Z, Cohen-Gadol AA, Masri LS, Morton DL, O’Day SJ, Essner R, Zelman V, Yu C, Luxton G, Apuzzo ML: Gamma knife radiosurgery for metastatic melanoma: an analysis of survival, outcome, and complications. Neurosurgery. 1999, 44: 59-64. 10.1097/00006123-199901000-00031. discussion 64–56 CrossRefPubMed
Decker DA, Decker VL, Herskovic A, Cummings GD: Brain metastases in patients with renal cell carcinoma: prognosis and treatment. J Clin Oncol. 1984, 2: 169-173. PubMed
Andrews DW, Scott CB, Sperduto PW, Flanders AE, Gaspar LE, Schell MC, Werner-Wasik M, Demas W, Ryu J, Bahary JP, Souhami L, Rotman M, Mehta MP, Curran WJ: Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet. 2004, 363: 1665-1672. 10.1016/S0140-6736(04)16250-8. CrossRefPubMed
Clarke JW, Register S, McGregor JM, Grecula JC, Mayr NA, Wang JZ, Li K, Gupta N, Kendra KL, Olencki TE, Cavaliere R, Sarkar A, Lo SS: Stereotactic radiosurgery with or without whole brain radiotherapy for patients with a single radioresistant brain metastasis. Am J Clin Oncol. 2010, 33: 70-74. 10.1097/COC.0b013e31819ccc8c. CrossRefPubMed
Jensen RL, Shrieve AF, Samlowski W, Shrieve DC: Outcomes of patients with brain metastases from melanoma and renal cell carcinoma after primary stereotactic radiosurgery. Clin Neurosurg. 2008, 55: 150-159. PubMed
Aoyama H, Shirato H, Tago M, Nakagawa K, Toyoda T, Hatano K, Kenjyo M, Oya N, Hirota S, Shioura H, Kunieda E, Inomata T, Hayakawa K, Katoh N, Kobashi G: Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. JAMA. 2006, 295: 2483-2491. 10.1001/jama.295.21.2483. CrossRefPubMed
- A concise review of the efficacy of stereotactic radiosurgery in the management of melanoma and renal cell carcinoma brain metastases
Peter W Hanson
Ameer L Elaimy
Wayne T Lamoreaux
John J Demakas
Robert K Fairbanks
Alexander R Mackay
Barton S Cooke
Sudheer R Thumma
Christopher M Lee
- BioMed Central
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