Locations:
Search IconSearch
February 13, 2018/Cancer

Outcome Snapshots: Stereotactic Radiosurgery for Brain Metastases

More patients being treated, with encouraging survival and functional outcomes

17-NEU-4298-Ahluwalia-Gamma-Knife-650×450

Brain metastases are a dreaded complication of lung and breast cancer, melanoma and other malignancies, as they are associated with poor prognosis: On average, patients survive approximately 12 months after diagnosis.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Gamma Knife® stereotactic radiosurgery (SRS), especially when used as an adjunct to other therapies, offers a better chance of longer survival. It delivers precise, highly focal control of brain metastases with few side effects. A major advantage of SRS compared with whole-brain radiation therapy is that patients need not stop the systemic therapy critical to optimal treatment of their primary cancer while undergoing SRS.

“Cleveland Clinic has more than 20 years of experience with Gamma Knife radiosurgery,” says Manmeet Ahluwalia, MD, Director of the Brain Metastasis Research Program and Head of Operations in Cleveland Clinic’s Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center. “Our center is a world leader in advancing the technique and refining which patient populations are most appropriate for therapy.”

More patients are benefiting

Data snapshots from Cleveland Clinic Neurological Institute’s 2016 Outcomes Book show that the number of patients undergoing Gamma Knife radiosurgery at Cleveland Clinic has nearly doubled in recent years, from 229 in 2012 to 434 in 2016 (see graph below).

Dr. Ahluwalia attributes these rising numbers to an increase in the number of patients with brain metastases as well as to the increasing role of SRS in the management of these patients.

Despite this expanding patient population for Gamma Knife therapy, safety outcomes in 2016 remained excellent: The 30-day survival rate was 98 percent, and 94 percent of patients lived for at least six months (see graph below).

Performance status maintained

Maintenance of cognitive function is always of concern with metastatic brain disease, whether patients are being treated with radiation therapy or other modalities, according to Dr. Ahluwalia. Cleveland Clinic routinely collects data on patients’ functional performance measures before and after Gamma Knife radiosurgery. The Karnofsky Performance Status scale is a standard tool used for patients with cancer to assess their ability to perform ordinary tasks.

Advertisement

Data on performance status were available for 221 patients who underwent SRS at Cleveland Clinic in 2016. They show that the vast majority of these patients (91 percent) either remained stable or improved following SRS (see graph below). A change in status was defined as a change of at least 20 points on the 100-point scale.

“Stereotactic radiosurgery is an important tool in our armamentarium for fighting metastatic brain disease,” says Dr. Ahluwalia. “It’s reassuring that routine measurement of outcomes demonstrates its safety. This modality is particularly exciting because it is an outpatient single-day procedure for most patients and can be more easily combined with targeted therapy and immunotherapy when compared to whole-brain radiation.”

For additional recent volume and outcomes data from the Burkhardt Brain Tumor and Neuro-Oncology Center, see the 2016 Outcomes Book from Cleveland Clinic Neurological Institute.

Advertisement

Related Articles

Cancer patient being hugged by a loved one
September 4, 2024/Cancer/Blood Cancers
Study Finds Immunotherapy Increases Three-Year Survival in Adults with B-Cell Precursor Acute Lymphoblastic Leukemia

Blinatumomab plus chemotherapy improves overall survival and relapse-free survival over chemotherapy alone

Doctor and team talking to patient in hospital bed
August 30, 2024/Cancer/Patient Support
New Cellular and Immunotherapy Service Provides Patients with Standard of Care and Clinical Trial Opportunities for Novel Therapies

Patients receive specialized inpatient and outpatient care for cellular, gene and immune cell-engaging therapies

Before and after scan
August 28, 2024/Cancer/Research
Case Study: Patient with Metastatic Urothelial Carcinoma Has No Remaining Evidence of Disease

Treatment involved checkpoint inhibitor, surgery and intravesical therapy

Dr. Maciejewski
August 23, 2024/Cancer/Research
Studies Evaluate Anti-Complement Inhibitors for Treating Paroxysmal Nocturnal Hemoglobinuria

Researchers Assess Real-Life Experiences of Patients Treated Outside of Clinical Trials

Dr. Raza
August 19, 2024/Cancer/Research
Understanding the Role of Palliative Care in AL Amyloidosis

Multi-specialty coordination essential for improving quality of life

Dr. Chirag Shah and colleague
August 12, 2024/Cancer/Research
DCISionRT Decision Score Predicts the Need of Radiation Therapy for Treating Ductal Carcinoma in Situ

Seven-gene biosignature becomes first effective means to reduce over- and under-treatment with radiation therapy

Diffuse large B-cell lymphoma
August 1, 2024/Cancer/Research
Emerging Second- and Third-Line Treatments Improve Outcomes in Diffuse Large B-Cell Lymphoma

CAR T-cell therapy, bispecifics and antibody drug conjugates have changed disease management

Ad