ИСТИНА

Preoperative stereotactic radiosurgery (pre-SRS) is a new strategy of management for brain metastases (BM). The goal of this analysis is to evaluate 6/12-month local control, overall survival and toxicity utilizing pre-operative SRS followed by surgical resection for patients with brain metastases. Materials and methods. 35 patients with 83 BM (22 female and 13 male) have been treated using SRS & pre-SRS. 47 symptomatic metastatic lesions were pre-SRS in the series. 8 patients had NSCLC, 9 - BC, 7 - melanoma, 5 - renal carcinoma and 6 - other. Median target volume for combined treatment was 12,26 cc (4,074 - 57,098). Median of target dose was 18,94 Gy (12 and 24,36). Radiation dose was increased by approximately 20% compared to standard dosing as per RTOG 90-05 and was determined by tolerance of intact brain tissues. Pre-SRS followed by delivered surgical resection within 48 hours (Me=24 hours). Results. All patients tolerated pre-SRS well, without any neurological deterioration, and surgical treatment was performed as scheduled. Median follow-up period was 11.3 months. Local recurrences were found in 3 cases. Local control was noted in 95.7% and 89.3% at 6 and 12 m respectively during follow-up. The median overall survival (OS) and 6 / 12 months OS rate were 17,1 months and 77,8/62,5 %, respectively. Radionecrosis was present in 3 pts. Conclusion: Pre-SRS confers excellent cavity local control with very low risk of RN. Pre-SRS confers excellent cavity local control with very low risk of RN. Optimal dose, technique and timing for presurgical irradiation has not been established yet.