Comparison Of Single-Fraction Stereotactic Radiosurgery And Surgical Resection For Brain Metastases At Least 4 Cc In Volume

Introduction: Brain metastases are the most common intracranial malignancies and are typically treated with surgical resection, radiation therapy, or both. Small lesions can be treated safely and effectively with stereotactic radiosurgery (SRS) or surgery. However, this is not as well-defined for larger lesions still amenable to SRS or surgery. This study was conducted to retrospectively analyze SRS and surgery for brain metastases at least 4 cubic centimeters (cc) in volume.Methods: We reviewed 177 patients with brain lesions ≥ 4 cc treated between March 2008 and July 2016 with either SRS (n = 123) or surgery (n = 54) for at least one malignant intracranial lesion. Patients were excluded if they had no follow-up records, had post-operative radiation, or had primary CNS malignancy on final pathology. Results: Median follow-up time for all patients was 3.7 months. The SRS group had a greater proportion of non-small cell lung cancer (NSCLC) patients (p = 0.001), better ECOG performance status (PS) (p For brain metastases ≥ 4 cc in volume amenable to SRS or surgery, this study reports better LR with SRS compared to surgery alone. On subgroup analysis, patients with primary NSCLC histology experienced improved median and 1-year survival with SRS compared to surgery. However, differences in outcomes could be due to selection bias and warrants further investigation with better control of baseline characteristics. Citation Format: Ahmad Ridwanur Rahman, Emily Daugherty, Ali Hazama, Ayesha Ropri, Margaret Formica, Anna Shapiro, Michael Lacombe, Lawrence Chin, Seung Hahn. Comparison of single-fraction stereotactic radiosurgery and surgical resection for brain metastases at least 4 cc in volume [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 6503.