Gustavo Viani: Time to Rethink Brain Metastasis Management
Gustavo Viani, Professor at the Faculty of Medicine of Botucatu, São Paulo State University (UNESP), shared on LinkedIn about a recent article by Haley K. Perlow et al., published in the Red Journal:
“Time to Rethink Brain Metastasis Management? Pre-Op FSRT Shows an Edge!
Objective
Evaluate whether pre-operative FSRT offers better outcomes than the standard post-operative FSRT in resected brain metastases.
Methods
- Retrospective cohort, 458 patients / 534 metastases
- Dose: 27 Gy/3 fx or 30 Gy/5 fx
- LINAC or Gamma Knife, margins 2–3 mm
Results
- Composite endpoint (LF, nMD, ≥G2 RN):
- Pre-op: 12% vs Post-op: 20% (p=0.018)
- Nodular meningeal disease: 1.7% vs 4.7%
- No OS difference, but clear toxicity reduction
Clinical Impact:
Pre-op FSRT may lower risk of meningeal disease & necrosis by targeting smaller volumes and sterilizing tumor cells.”
Title: Pre-Operative Versus Post-Operative Fractionated Stereotactic Radiotherapy: A Single Institution Analysis of 534 Resected Metastases
Journal: Red Journal
Authors: Haley K. Perlow, Sarah Hennings, Jared Bradshaw, Sohil Reddy, Sydney Luu, Jennifer K. Matsui, Brett G. Klamer, Khaled Dibs, Marshall Harrell, John M. McGregor, Russell R. Lonser, Daniel M. Prevedello, James B. Elder, Kyle C. Wu, Roshan Prabhu, Simeng Zhu, Raj Singh, Sasha J. Beyer, John Grecula, Dukagjin M. Blakaj, Evan M. Thomas, Raju R. Raval, Joshua D. Palmer
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