Brain Tumours – Brain Metastases
The standard treatment for patients with one or two brain metastases is removal by microsurgery. Yet microsurgery is not usually an option for patients with metastases in delicate parts of the brain, patients with multiple brain metastases and those with an increased risk for problems associated with operations or anaesthetics. In these patients radiosurgery is often the only effective alternative treatment. Numerous scientific studies show that the efficacy of radiosurgery is comparable with that of open microsurgery to remove tumours. Radiosurgical treatment causes either tumour shrinkage or stops tumour growth in the short term in 90% of cases and in the long term in 80% of cases. As a rule the onset of this effect comes at four to eight weeks after the treatment.
Approx. 10% of patients may experience side-effects at four to twelve months after the treatment. This is generally local swelling in combination with enhanced contrast medium (dye) uptake in check-ups using magnetic resonance imaging (MRI). If the swelling causes other symptoms (in 5% of patients), this can usually be effectively treated with cortisone. If the patient does not have any symptoms, or if the cortisone is successful, the doctor will generally wait and conduct another MRI check-up at a later date. Symptom-free reactions to the radiation do not need any specific treatment. In about 1 to 3% of cases an uncontrollable swelling occurs. This can lead to lasting neurological deficits. It may then be necessary for the patient to undergo an operation for resection of the destroyed cancer tissue.
Restrictions on the method
Tumours larger than 3 cm represent a problem because they compress the adjacent tissue. An operation is the only option for short-term relief and creating the conditions necessary for reduction of the symptoms. Radiosurgical treatment is not indicated in such cases. Because the occurrence of side-effects depends on the total dose of radiation, there is also a restriction due to the number of tumours to be treated.
MetastasenGebFra2004.pdf (1 MB)