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Usachev D.Yu.
Burdenko Neurosurgical Center;
Russian Medical Academy of Continuous Professional Education
Kobyakov N.G.
Russian Medical Academy of Continuous Professional Education
Comparative analysis of combined treatment methods for patients with single brain lesions
Journal: Burdenko's Journal of Neurosurgery. 2024;88(4): 13‑21
Views: 701
Downloaded: 52
To cite this article:
Ostapenko MYu, Lukshin VA, Usachev DYu, Golanov AV, Vetlova ER, Durgaryan AA, Kobyakov NG. Comparative analysis of combined treatment methods for patients with single brain lesions. Burdenko's Journal of Neurosurgery.
2024;88(4):13‑21. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20248804113
Primary brain metastases are common in oncology. Preoperative stereotactic radiosurgery followed by surgical resection is a perspective approach.
To evaluate own experience of preoperative radiosurgery followed by surgical resection (RS+S) of metastasis regarding local control, leptomeningeal progression, surgical and radiation-induced complications; to compare treatment outcomes with surgical resection and subsequent radiotherapy (S+SRT).
Retrospective study included 66 patients with solitary brain metastasis. Two groups of patients were distinguished: group 1 (n=34) — postoperative irradiation, group 2 (n=32) — preoperative irradiation. The median age was 49.5 years (range 36—75).
Local 3-, 6- and 12-month control among patients with postoperative irradiation was 88.2%, 79.4% and 42.9%, in the group of preoperative irradiation — 100%, 93.3% and 66.7%, respectively (p=0.021). Leptomeningeal progression developed in 11 patients (8 and 3 ones, respectively). The one-year survival rate was 73.5% and 84.4%, respectively (p=0.33). Long-term surgical and radiation-induced complications occurred in 12 (18.2%) patients.
Preoperative radiosurgery with subsequent resection provides higher local control and lower incidence of leptomeningeal progression in patients with single brain metastases.
Keywords:
Authors:
Usachev D.Yu.
Burdenko Neurosurgical Center;
Russian Medical Academy of Continuous Professional Education
Kobyakov N.G.
Russian Medical Academy of Continuous Professional Education
Received:
23.02.2024
Accepted:
31.05.2024
List of references:
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