AccScience Publishing / ARNM / Volume 2 / Issue 1 / DOI: 10.36922/arnm.2231
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Gamma knife radiosurgery following whole-brain radiation

Natasha Mathur1 Badal Juneja2 Alan Turtz3 Howard Warren Goldman3 Qianyi Xu2 Dave Mulvihill2 Gregory J. Kubicek2*
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1 Cooper Medical School of Rowan University, Camden, New Jersey, United States of America
2 Department of Radiation Oncology, MD Anderson-Cooper Cancer Center, Camden, New Jersey, United States of America
3 Department of Neurological Surgery, Cooper University Hospital, One Cooper Plaza, Camden, New Jersey, United States of America
Submitted: 11 November 2023 | Accepted: 11 March 2024 | Published: 28 March 2024
© 2024 by the Author (s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( )

In this study, we aimed to determine outcomes for patients requiring salvage stereotactic radiosurgery (SRS) who have progression of brain metastatic disease after initial treatment with whole-brain radiation (WBRT). This is a retrospective analysis of a prospective database of 112 patients who were treated with salvage SRS after experiencing failure following WBRT treatment with salvage SRS. Collectively, the patients had a median overall survival of 7 months after salvage SRS. Patients who had more than two brain metastases had a significantly shorter median survival but were not subjected to increased risk for distant brain failure. We also found that a short intervening time between WBRT and central nervous system (CNS) failure did not seem to worsen the nervous system control or reduce patient survival. Small cell lung cancer (SCLC) was associated with decreased overall survival and CNS control. In conclusion, SRS use following WBRT is safe and effective in the majority of patients. Patients with rapid failure after WBRT can be successfully salvaged with SRS. The findings also shed light on the overall poor outcomes, coupled with low median survival and high rates of CNS failure, in patients suffering multiple metastases stemming from SCLC.

Stereotactic radiosurgery
Radiation therapy
Central nervous system
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Conflict of interest
The authors declare that they have no competing interests.
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Advances in Radiotherapy & Nuclear Medicine, Electronic ISSN: 2972-4392 Published by AccScience Publishing