Comparison Between Stereotactic Radiosurgery And Surgical Resection In Patients With A Single Brain Metastasis

BackgroundBrain metastasis is one of the important clinical problems for cancer patients.Approximately 20%to 40%of patients with cancer w:ill develop brain metastases eventually.Patients with brain metastases usually have poor prognosis.Nearly half of theses patients have a single brain lesion at diagnosis.Both of surgical resection and stereotactic radiosurgery are effective management modalities for single brain metastasis.Although treatment guidelines exist for single brain metastasis,there remains no convincing evidence.MethodsBetween January 2011 and December 2015,92 patients with single brain metastasis were treated at our institution.59 patients underwent SRS and 33 patients underwent SR.Survival was calculated using the Kaplan-Meier method.Cox regression modeling was used for univariate and multivariate analysis.ResultsThe median follow-up timewas 15 months.The 6-month local control rate was 86.4%in patients in the SRS group and 90.6%in patients in the SR group(P=0.526).The median survival was 15 months in the SRS group and 14 months in the SR group(P=0.919).The 1 year survival was 59.3%in the SRS group and 63.6%in the SR group(P=0.684).The univariate analysis estimates that extracranial disease,KPS score and RPA classification were significant prognostic factors for survival.Multivariate analyses revealed KPS score as an independent factor associated with prolonged survival.ConclusionBoth of SRS and SR are effective treatment for single brain metastasis.No statistically significant difference was found in overall survival,local tumor control and symptom resolution,even in patients with brain metastases>3cm.SRS is a superior for brain metastases<3 cm and in eloquent locations.