{Reference Type}: Journal Article
{Title}: Local control and survival after stereotactic radiosurgery for colorectal cancer brain metastases: an international multicenter analysis.
{Author}: Bin-Alamer O;Abou-Al-Shaar H;Singh R;Mallela AN;Legarreta A;Bowden G;Mathieu D;Perlow HK;Palmer JD;Elhamdani S;Shepard M;Liang Y;Nabeel AM;Reda WA;Tawadros SR;Abdelkarim K;El-Shehaby AMN;Emad Eldin R;Elazzazi AH;Warnick RE;Gozal YM;Daly M;McShane B;Addis-Jackson M;Karthikeyan G;Smith S;Picozzi P;Franzini A;Kaisman-Elbaz T;Yang HC;Hess J;Templeton K;Zhang X;Wei Z;Pikis S;Mantziaris G;Simonova G;Liscak R;Peker S;Samanci Y;Chiang V;Kersh CR;Lee CC;Trifiletti DM;Niranjan A;Hadjipanayis CG;Lunsford LD;Sheehan JP;
{Journal}: J Neurosurg
{Volume}: 140
{Issue}: 5
{Year}: 2024 May 1
{Factor}: 5.408
{DOI}: 10.3171/2023.8.JNS231231
{Abstract}: <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.