Comparative analysis of combined treatment methods for patients with single brain lesions

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

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)

Использование инфографики авторами научных работ

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OBJECTIVE

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).

MATERIAL AND METHODS. A

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).

RESULTS

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.

CONCLUSION

Preoperative radiosurgery with subsequent resection provides higher local control and lower incidence of leptomeningeal progression in patients with single brain metastases.

Keywords:

metastasis

preoperative radiation

postoperative radiation

radiosurgery

whole-brain radiation therapy

local control

radiation necrosis

Authors:

Ostapenko M.Yu.

Burdenko Neurosurgical Center

ORCID: 0000-0002-0525-040X

Lukshin V.A.

Burdenko Neurosurgical Center

ORCID: 0000-0001-5787-484X

Usachev D.Yu.

Burdenko Neurosurgical Center;
Russian Medical Academy of Continuous Professional Education

ORCID: 0000-0002-9811-9442

Golanov A.V.

Burdenko Neurosurgical Center

ORCID: 0000-0002-0976-4547

Vetlova E.R.

Burdenko Neurosurgical Center

ORCID: 0000-0002-4904-0324

Durgaryan A.A.

Burdenko Neurosurgical Center

ORCID: 0000-0003-3024-2935

Kobyakov N.G.

Russian Medical Academy of Continuous Professional Education

ORCID: 0000-0001-5975-7188

Received:

23.02.2024

Accepted:

31.05.2024

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References:

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