%0 Journal Article
%T Local control and survival after stereotactic radiosurgery for colorectal cancer brain metastases: an international multicenter analysis.
%A Bin-Alamer O
%A Abou-Al-Shaar H
%A Singh R
%A Mallela AN
%A Legarreta A
%A Bowden G
%A Mathieu D
%A Perlow HK
%A Palmer JD
%A Elhamdani S
%A Shepard M
%A Liang Y
%A Nabeel AM
%A Reda WA
%A Tawadros SR
%A Abdelkarim K
%A El-Shehaby AMN
%A Emad Eldin R
%A Elazzazi AH
%A Warnick RE
%A Gozal YM
%A Daly M
%A McShane B
%A Addis-Jackson M
%A Karthikeyan G
%A Smith S
%A Picozzi P
%A Franzini A
%A Kaisman-Elbaz T
%A Yang HC
%A Hess J
%A Templeton K
%A Zhang X
%A Wei Z
%A Pikis S
%A Mantziaris G
%A Simonova G
%A Liscak R
%A Peker S
%A Samanci Y
%A Chiang V
%A Kersh CR
%A Lee CC
%A Trifiletti DM
%A Niranjan A
%A Hadjipanayis CG
%A Lunsford LD
%A Sheehan JP
%J J Neurosurg
%V 140
%N 5
%D 2024 May 1
%M 37948682
%F 5.408
%R 10.3171/2023.8.JNS231231
%X <B>OBJECTIVE: </B>The goal of this study was to characterize local tumor control (LC), overall survival (OS), and safety of stereotactic radiosurgery for colorectal brain metastasis (CRBM).<BR><B>METHODS: </B>Ten international institutions participating in the International Radiosurgery Research Foundation provided data for this retrospective case series. This study included 187 patients with CRBM (281 tumors), with a median age of 62 years and 56.7% being male. Most patients (53.5%) had solitary tumors, although 10.7% had > 5 tumors. The median tumor volume was 2.7 cm3 (IQR 0.22-8.1 cm3), and the median margin dose was 20 Gy (IQR 18-22 Gy).<BR><B>RESULTS: </B>The 3-year LC and OS rates were 72% and 20%, respectively. Symptomatic adverse radiation effects occurred in 1.6% of patients. In the multivariate analysis, age > 65 years and tumor volume > 4.0 cm3 were significant predictors of tumor progression (hazard ratio [HR] 2.6, 95% CI 1.4-4.9; p = 0.003 and HR 3.4, 95% CI 1.7-6.9; p < 0.001, respectively). Better performance status (Karnofsky Performance Scale score > 80) was associated with a reduced risk of tumor progression (HR 0.38, 95% CI 0.19-0.73; p = 0.004). Patient age > 62 years (HR 1.6, 95% CI 1.1-2.3; p = 0.03) and the presence of active extracranial disease (HR 1.7, 95% CI 1.1-2.4; p = 0.009) were significantly associated with worse OS.<BR><B>CONCLUSIONS: </B>Stereotactic radiosurgery offers a high LC rate and a low rate of symptomatic adverse radiation effects for the majority of CRBMs. The OS and LC favored younger patients with high functional performance scores and inactive extracranial disease.