Stereotactic radiosurgery vs. whole-brain radiation for treating brain tumors

A new study led by researchers from the University of Missouri School of Medicine compared two common postsurgical therapies for metastatic brain tumors, the most common in adults, and found that stereotactic radiosurgery can provide improved outcomes for patients compared to whole-brain radiation.

The study, published in Cureus, examined whole-brain radiation therapy—where beams of radiation treat the entire brain—which is known to negatively affect a patient’s cognitive functions and quality of life. Researchers compared such treatments to stereotactic radiosurgery, which directs radiation to precise areas of the brain. Because of the targets to specific area, there is less damage being done to health brain tissue causing less cognitive decline compared to whole-brain radiation.

“Although radiosurgery has been shown to be an effective post-surgery treatment for metastatic brain tumors, previous studies did not compare patient outcomes from a single hospital over the same period of time,” said N. Scott Litofsky, MD, chief of the Division of Neurological Surgery at the MU School of Medicine and senior author of the study said in a press release. “Our study is one of the first to directly compare outcomes of patients treated at the same hospital during a set period of time. Ultimately, our findings reinforce the use of radiosurgery over whole-brain radiation.”

Patients who were treated at MU Health Care from 2010 to 2014 were studied. Of those assessed, 46 patients received whole-brain radiation, while 37 received radiosurgery after undergoing brain surgery to remove a metastatic tumor. Researchers found that radiosurgery controlled the spread of the cancerous cells just as much as whole-brain radiation. In addition, there was much less harm done to those patients who received radiosurgery. The median survival rates for patients who received radiosurgery was 440 days, compared to 202 days for patients who received whole-brain radiation.

“For patients with metastatic cancer of the brain, the importance of surviving for a longer period of time cannot be overstated,” said Liofsky. “ In our practice, we not treat patients almost exclusively with radiosurgery following their surgery. Although this therapy does cost more, results often can be achieved in one to three visits compared to 10 to 12 visits for whole-brain radiation. With these consideration, we strongly suggest physicians consider radiosurgery as an initial radiation treatment after surgery.”