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After surgery to remove a brain metastasis, focused radiosurgery to the cavity preserved thinking and memory far better than whole-brain radiotherapy and gave the same survival, so it became the standard.
Phase 3 trial of 194 patients with one resected brain metastasis (and up to three unresected) randomised to stereotactic radiosurgery to the surgical cavity or whole-brain radiotherapy.
Cognitive deterioration-free survival was 3.7 versus 3.0 months (hazard ratio 0.47) and cognitive decline at six months was 52 versus 85 percent; overall survival was similar (12.2 versus 11.6 months) although whole-brain radiotherapy gave better intracranial control.
Surgical cavity radiosurgery, rather than whole-brain radiotherapy, follows resection of a brain metastasis in fit patients, part of the broader move away from whole-brain treatment.
Shares Paul D. Brown, Brain metastases (secondary brain tumours).
Shares Paul D. Brown, Brain metastases (secondary brain tumours).