Journal article
Multicenter Retrospective Study of Stereotactic Radiosurgery for Gynecological Cancer Brain Metastases
Neurosurgery, v 98(1), pp 194-203
Jan 2026
PMID: 40622139
Abstract
BACKGROUND AND OBJECTIVES:Gynecological cancers represent 10% to 15% of cancers in women, but brain metastases (BM) are uncommon, with limited evidence regarding their management. This study investigates the role of stereotactic radiosurgery (SRS) for BM from primary gynecological cancers.METHODS:Institutions of the International Radiosurgery Research Foundation participated in this study. Inclusion criteria required histological diagnosis of epithelial ovarian, cervical, or endometrial cancer, SRS between 2000 and 2020, and at least 1 imaging or clinical follow-up.RESULTS:A total of 276 patients having SRS for 977 BM were included. Median age at SRS was 62 years (IQR, 55-70). Primary cancer origin was ovarian in 128 (46%), cervical in 43 (16%), and endometrial in 105 patients (38%). Median Karnofsky Performance Scale was 80%, and systemic disease was active in 124 (45%) of patients. A median of 1 metastasis was treated (IQR, 1-3) per patient. Median individual metastasis volume was 0.27 cc (IQR, 0.05-1.59 cc). The majority (91%) received single-fraction SRS, using a median margin dose of 18 Gy (IQR, 16-20 Gy). Actuarial overall survival was 77%, 65%, and 44% at 6, 12, and 24 months, respectively. Predictors of worsened survival included older age, cervical and endometrial primary, previous whole-brain radiation therapy (WBRT), active systemic disease, worsened Karnofsky Performance Scale, absence of subsequent surgery, and increasing number of BM. Actuarial local control was 94% at 6 months, 89% at 12 months, and 78% at 24 months. Previous SRS or WBRT, tumor bed treatment, and cervical histology increased the risk of local failure. New remote BM and leptomeningeal dissemination occurred in 44% and 11% of patients, respectively. Adverse radiation effects (ARE) occurred in 13% of cases but were symptomatic in only 3%. Previous WBRT or SRS and increased tumor diameter increased the risk of ARE.CONCLUSION:SRS is an effective management for BM from gynecological cancers with low risks of symptomatic ARE.
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Details
- Title
- Multicenter Retrospective Study of Stereotactic Radiosurgery for Gynecological Cancer Brain Metastases
- Creators
- Mathilde Billau - Université de SherbrookeAndréanne Hamel - Université de SherbrookeJean-Nicolas Tourigny - Centre Hospitalier Universitaire de SherbrookeChristian Iorio-Morin - Université de SherbrookeRoman Liscak - Na Homolce HospitalJaromir May - Na Homolce HospitalAjay Niranjan - University of PittsburghZhishuo Wei - Neurological SurgeryL. Dade Lunsford - University of PittsburghDiego D. Luy - Neurological SurgeryShalini Jose - Neurological SurgerySydney Scanlon - Neurological SurgeryJoshua Silverman - NYU Langone HealthReed Mullen - NYU Langone HealthKenneth Bernstein - NYU Langone HealthDouglas Kondziolka - NYU Langone HealthSelcuk Peker - Koç UniversityYavuz Samanci - ,Steve Braunstein - University of California, San FranciscoChristina Phuong - University of California, San FranciscoJason Sheehan - University of Virginia Health SystemStylianos Pikis - University of Virginia Health SystemJacob Kosyakovsky - University of Virginia Health SystemRahul Neal Prasad - The Ohio State University Wexner Medical CenterJoshua David Palmer - The Ohio State University Wexner Medical CenterDavid Bailey - Pennsylvania State UniversityBrad E. Zacharia - Pennsylvania State UniversityChristopher P. Cifarelli - West Virginia UniversityDenisse Arteaga Icaza - West Virginia UniversityDaniel T. Cifarelli - West Virginia UniversityRodney E. Wegner - Allegheny Health NetworkMatthew J. Shepard - Allegheny Health NetworkGregory N. Bowden - University of AlbertaNarine Wandrey - University of Colorado DenverChad G. Rusthoven - University of Colorado DenverEric B. Hintz - Donald & Barbara Zucker School of Medicine at Hofstra/NorthwellMichael Schulder - Donald & Barbara Zucker School of Medicine at Hofstra/NorthwellAnuj Goenka - Donald & Barbara Zucker School of Medicine at Hofstra/NorthwellJennifer L. Peterson - WinnMedDavid Mathieu - Université de Sherbrooke
- Publication Details
- Neurosurgery, v 98(1), pp 194-203
- Publisher
- Wolters Kluwer; PHILADELPHIA
- Number of pages
- 10
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:001681098700013
- Scopus ID
- 2-s2.0-105010281068
- Other Identifier
- 991022154807204721