Radiosurgical Management of Brainstem Metastasis

Main Article Content

Erkan Topkan
Ahmet Kucuk
Nulifer Kilic Durankus
Sukran Senyurek
Eyub Yasar Akdemir
Duygu Sezen
Esma Didem Ikiz
Yasemin Bolukbasi
Berrin Pehlivan
Ugur Selek

Abstract

Brainstem metastases account only for 3% to 5% of all intracranial metastasis. However, brainstem metastases undoubtedly represent a significant source of severe morbidity and mortality in affected patients with estimated average survival duration of only less than 6 months. Surgical resection is not suitable for most brainstem metastases due to the vital architectural structure of the brainstem. What’s more, most conventional chemotherapeutics and targeted agents are ineffective on account of their low blood-brain-barrier penetration capacities. Accordingly, palliative short-course whole-brain radiotherapy stays to be the present standard of care for brainstem metastases. Nonetheless, the limited efficacy of WBRT and related neurocognitive toxicity concerns prompted eagerness on the utilization of stereotactic radiosurgery for brainstem metastases in like manner the cerebral and cerebellar metastases. In a shortage of reliable large series outcomes, the present review article meant to succinctly summarize the current stereotactic radiosurgery evidence on brainstem metastases with an explicit accentuation on the feasibility and efficacy of this novel sophisticated radiotherapy technique in such patients’ groups of bleak prognoses.

Keywords:
Brainstem metastases, stereotactic radiosurgery, local control, survival, complications

Article Details

How to Cite
Topkan, E., Kucuk, A., Durankus, N. K., Senyurek, S., Akdemir, E. Y., Sezen, D., Ikiz, E. D., Bolukbasi, Y., Pehlivan, B., & Selek, U. (2020). Radiosurgical Management of Brainstem Metastasis. International Research Journal of Oncology, 3(1), 37-46. Retrieved from http://journalirjo.com/index.php/IRJO/article/view/30123
Section
Review Article

References

Tosoni A, Ermani M, Brandes AA. The pathogenesis and treatment of brain metastases: A comprehensive review. Crit. Rev. Oncol. Hematol. 2004;52:199-215.

Patchell RA. Metastatic brain tumors. Neurol. Clin. 1195;3(4):915-25.

Trifiletti DM, Lee CC, Shah N, Patel NV, Chen SC, Sheehan JP. How does brainstem involvement affect prognosis in patients with limited brain metastases? Results of a matched-cohort analysis. World Neurosurg. 2016;88:563-8.

Peterson HE, Larson EW, Fairbanks RK, et al. Gamma Knife radiosurgery treatment for metastatic melanoma of the trigeminal nerve and brainstem: A case report and a review of the literature. Case Rep. Neurol. Med. 2013;2013:256962.

Yen C.P, Sheehan J, Patterson G, Steiner L. Gamma Knife surgery for metastatic brainstem tumors. J. Neurosurg. 2006; 105:213-9.

Trifiletti DM, Lee CC, Kano H, et al. Stereotactic Radiosurgery for Brainstem Metastases: An International Cooperative Study to Define Response and Toxicity. Int J Radiat Oncol Biol Phys. 2016;96(2):280-8.

Linskey ME, Andrews DW, Asher AL, et al. The role of stereotactic radiosurgery in the management of patients with newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline. J Neurooncol. 2010; 96(1):45-68.

Huang CF, Kondziolka D, Flickinger JC, Lunsford LD. Stereotactic radiosurgery for brainstem metastases. J Neurosurg. 1999; 91(4):563-8.

Shuto T, Fujino H, Asada H, Inomori S, Nagano H. Gamma knife radiosurgery for metastatic tumours in the brain stem. Acta Neurochir (Wien). 2003;145(9):755-60.

Fuentes S, Delsanti C, Metellus P, et al. Brainstem metastases: management using gamma knife radiosurgery. Neurosurgery. 2006;58(1):37-2.

Yen CP, Sheehan J, Patterson G, Steiner L. Gamma knife surgery for metastatic brainstem tumors. J Neurosurg. 2006; 105(2):213-9.

Hussain A, Brown PD, Stafford SL, Pollock BE. Stereotactic radiosurgery for brainstem metastases: Survival, tumor control, and patient outcomes. Int J Radiat Oncol Biol Phys. 2007;67(2):521-4.

Kased N, Huang K, Nakamura JL, et al. Gamma knife radiosurgery for brainstem metastases: the UCSF experience. J Neurooncol. 2008;86(2):195-205.

Lorenzoni JG, Devriendt D, Massager N, et al. Brain stem metastases treated with radiosurgery: prognostic factors of survival and life expectancy estimation. Surg Neurol. 2009;71(2):188-95.

Koyfman SA, Tendulkar RD, Chao ST, et al. Stereotactic radiosurgery for single brainstem metastases: the cleveland clinic experience. Int J Radiat Oncol Biol Phys. 2010;78(2):409-14.

Kelly PJ, Lin YB, Yu AY, et al. Linear accelerator-based stereotactic radio-surgery for brainstem metastases: the Dana-Farber/Brigham and Women's Cancer Center experience. J Neurooncol. 2011;104(2):553-7.

Yoo TW, Park ES, Kwon DH, Kim CJ. Gamma knife radiosurgery for brainstem metastasis. J Korean Neurosurg Soc. 2011;50(4):299-303.

Hatiboglu MA, Chang EL, Suki D, et al. Outcomes and prognostic factors for patients with brainstem metastases undergoing stereotactic radiosurgery. Neurosurgery. 2011;69(4):796-806.

Valery CA, Boskos C, Boisserie G, et al. Minimized doses for linear accelerator radiosurgery of brainstem metastasis. Int J Radiat Oncol Biol Phys. 2011;80(2):362-8.

Kawabe T, Yamamoto M, Sato Y, et al. Gamma Knife surgery for patients with brainstem metastases. J Neurosurg. 2012;117 Suppl:23-30.

Li Y, Xu D, Zhang Z, et al. Gamma Knife surgery for brainstem metastases. J Neurosurg. 2012;117 Suppl:13-6.

Lin CS, Selch MT, Lee SP, et al. Accelerator-based stereotactic radio-surgery for brainstem metastases. Neurosurgery. 2012;70(4):953-8.

Jung EW, Rakowski JT, Delly F, et al. Gamma knife radiosurgery in the management of brainstem metastases. Clin Neurol Neurosurg. 2013;115(10): 2023-8.

Sengoz M, Kabalay IA, Tezcanlı E, Peker S, Pamir N. Treatment of brainstem metastases with gamma-knife radio-surgery. J Neurooncol. 2013;113(1): 33-8.

Peterson HE, Larson EW, Fairbanks RK, et al. Gamma knife treatment of brainstem metastases. Int J Mol Sci. 2014;15(6): 9748-61.

Kilburn JM, Ellis TL, Lovato JF, et al. Local control and toxicity outcomes in brainstem metastases treated with single fraction radiosurgery: is there a volume threshold for toxicity? J Neurooncol. 2014;117(1): 167-74.

Trifiletti DM, Lee CC, Winardi W, et al. Brainstem metastases treated with stereotactic radiosurgery: safety, efficacy, and dose response. J Neurooncol. 2015; 125(2):385-92.

Voong KR, Farnia B, Wang Q, et al. Gamma knife stereotactic radiosurgery in the treatment of brainstem metastases: The MD Anderson experience. Neurooncol Pract. 2015;2(1):40-7.

Liu SH, Murovic J, Wallach J, et al. Cyber Knife radiosurgery for brainstem meta-stases: Management and outcomes and a review of the literature. J Clin Neurosci. 2016;25:105-10.

Joshi R, Johnson MD, Maitz A, et al. Utility of graded prognostic assessment in evaluation of patients with brainstem metastases treated with radiosurgery. Clin Neurol Neurosurg. 2016;147:30-3.

Nakamura M, Nishimura H, Mayahara H, et al. Investigation of the efficacy and safety of CyberKnife hypofractionated stereotactic radiotherapy for brainstem metastases using a new evaluation criterion: 'symptomatic control'. J Radiat Res. 2017;58(6):834-9.

Murray L, Menard C, Zadeh G, et al. Radiosurgery for brainstem metastases with and without whole brain radiotherapy: clinical series and literature review. J Radiat Oncol. 2017;6(1):21-30.

Emery A, Trifiletti DM, Romano KD, et al. More than just the number of brain metastases: evaluating the impact of brain metastasis location and relative volume on overall survival after stereotactic radio-surgery. World Neurosurg. 2017;99: 111-7.

Patel A, Mohammadi H, Dong T, et al. Brainstem metastases treated with Gamma Knife stereotactic radiosurgery: the Indiana University Health experience. CNS Oncol. 2018;7(1):15-23.

Sinclair G, Benmakhlouf H, Martin H, Maeurer M, Dodoo E. Adaptive hypo-fractionated gamma knife radio-surgery in the acute management of brainstem metastases. Surg Neurol Int. 2019;10: 14.

Patel A, Dong T, Ansari S, et al. Toxicity of radiosurgery for brainstem metastases. World Neurosurg. 2018;119:e757-64.

Trifiletti DM, Lee CC, Kano H, et al. Stereotactic radiosurgery for brainstem metastases: an international cooperative study to define response and toxicity. Int J Radiat Oncol Biol Phys. 2016;96(2):280-8.

Sharma MS, Kondziolka D, Khan A,.et al. Radiation tolerance limits of the brainstem. Neurosurgery. 2008;63(4):728-33.

Mayo C, Yorke E, Merchant TE. Radiatıon Associated Brainstem Injury. Int J Radiat Oncol Biol Phys. 2010; 76(3 Suppl):S36-S41.

Shuto T, Fujino H, Asada H, Inomori S, Nagano H. Gamma knife radiosurgery for metastatic tumours in the brain stem. Acta Neurochirurgica. 2003;145(9):755-60.

Meeks SL, Buatti JM, Foote KD, Friedman WA, Bova FJ. Calculation of cranial nerve complication probability for acoustic neuroma radiosurgery. Int J Radiat Oncol Biol Phys. 2000;47(3):597-602.

Sinclair G, Benmakhlouf H, Brigui M, Maeurer M, Dodoo E. The concept of rapid rescue radiosurgery in the acute management of critically located brain metastases: A retrospective short-term outcome analysis. Surg Neurol Int. 2018;9: 218.