Fractionated radiation improved local control after brain metastasis surgery

A randomized trial found that fractionated stereotactic radiosurgery (SRS) improved control of the surgical bed after removal of a large brain metastasis, compared with single-fraction SRS. The trial randomized 242 patients with up to four brain metastases, including one resected metastasis at least 2 cm. MedPage Today reported that 223 patients were evaluable for the primary endpoint.

At 1 year, surgical-bed control was 87% with fractionated SRS and 81% with single-fraction SRS. Median overall survival, a secondary endpoint, was 28.6 months and 20.2 months, respectively. Freedom from whole-brain radiation at 1 year was 94% with fractionated treatment and 84% with single-fraction treatment. Ayal Aizer, who presented the results at an American Society for Radiation Oncology meeting, said the survival difference needs further study. The reports said toxicity did not meaningfully differ between the groups.