Local Radiation Provides Comparable Control of Brain Metastases Compared to Surgery, Study Shows

PHILADELPHIA (September 27, 2017) – An analysis led by researchers at Fox Chase Cancer Center in collaboration with the European Organization for the Research and Treatment of Cancer found that treating cancer that has metastasized to the brain with focal, high-dose radiation yields improved early results compared with surgical removal. Patients who underwent stereotactic radiosurgery (SRS), a type of precisely targeted radiation therapy, had a lower chance of recurrence of brain metastases for the first several months after treatment compared to those whose lesions were surgically removed. The advantage of SRS, however, diminished over time, and beginning nine months post-treatment, control favored surgery.

Thomas Churilla, MD, a senior radiation oncology resident at Fox Chase, led the study and will present it at an oral session at the annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) in San Diego on September 27. It has been chosen for distinction at the “Scientific Highlights” program, emphasizing high-scoring and high-impact work.

Some of the most commonly diagnosed cancers— lung, breast, colorectal, and melanoma— are also among those most likely to spread to the brain. Earlier research has demonstrated that both surgery and radiosurgery provide better local control, and in select patients a survival benefit, compared to whole brain radiotherapy alone. More recently investigators have examined using surgery or radiosurgery alone for brain metastasis and deferring whole brain radiation in order to reduce treatment-related toxicity. However no robust head-to-head comparison between these two focal modalities has ever been successfully conducted.

“Our analysis shows that for most patients, stereotactic radiosurgery provides control of metastatic brain lesions comparable to surgical removal in a non-invasive fashion. To our knowledge, this is the highest quality and largest data-set comparing these two modalities,” said Churilla.

Last year Churilla won ASTRO's 2016 Clinical Science Research Abstract Award, which recognizes the top research presented by medical residents.

Fox Chase Cancer Center (Fox Chase), which includes the Institute for Cancer Research and the American Oncologic Hospital and is a part of Temple Health, is one of the leading comprehensive cancer centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase is also one of just 10 members of the Alliance of Dedicated Cancer Centers. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence six consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship, and community outreach. It is the policy of Fox Chase Cancer Center that there shall be no exclusion from, or participation in, and no one denied the benefits of, the delivery of quality medical care on the basis of race, ethnicity, religion, sexual orientation, gender, gender identity/expression, disability, age, ancestry, color, national origin, physical ability, level of education, or source of payment.

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