Re-irradiation followed by resection for recurrent brain metastases after initial stereotactic radiosurgery: illustrative cases.

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Tác giả: Toshinori Hasegawa, Takenori Kato, Shunichiro Kuramitsu, Kyoko Kuwabara, Akihiro Mizuno, Takehiro Naito, Masasuke Ohno, Hiroyuki Oishi, Yosuke Sakai

Ngôn ngữ: eng

Ký hiệu phân loại: 920.71 Men

Thông tin xuất bản: United States : Journal of neurosurgery. Case lessons , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 184990

BACKGROUND: The management of recurrent brain metastases after initial stereotactic radiosurgery (SRS) remains challenging, with high local recurrence rates following salvage surgery. While preoperative SRS has shown promise for newly diagnosed metastases, its application in post-SRS recurrences is largely unexplored. OBSERVATIONS: The authors treated three patients with recurrent brain metastases using preoperative re-irradiation followed by resection. Gamma Knife SRS was performed at marginal doses of 16-18 Gy, followed by resection within 24-48 hours. Local control was achieved in all patients without radiation-related complications. Histopathological examination confirmed the presence of viable tumor cells and radiation-induced changes. Follow-up magnetic resonance imaging revealed no evidence of tumor recurrence or adverse effects. Two patients remained alive at 35 and 19 months, whereas one died of primary cancer progression at 20 months. LESSONS: Preoperative re-irradiation followed by resection for recurrent brain metastases after initial SRS is feasible and offers promise for short-term safety, local control, and rapid symptom improvement. The ability to promptly implement SRS enables its application in oncological emergencies. These findings suggest that preoperative re-irradiation can be a valuable strategy for managing symptomatic post-SRS recurrent brain metastases that require prompt surgical intervention. https://thejns.org/doi/10.3171/CASE24737.
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