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RATIONALE: Stereotactic radiosurgery may be able to send x-rays directly to the tumor and cause less damage to normal tissue. Giving stereotactic radiosurgery before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed.
- To estimate the rate of recurrence at the surgical site in patients with brain metastases treated with neoadjuvant stereotactic radiosurgery (SRS) compared with historical data documenting recurrence at the surgical site after surgical resection and whole-brain radiotherapy (WBRT).
- To estimate the rate of salvage WBRT, SRS, or surgery in patients treated with neoadjuvant SRS alone.
- To determine the volume of adjacent normal brain parenchyma irradiated in these patients.
- To estimate the rate of new brain metastases outside of the neoadjuvant SRS site in these patients.
- To estimate the quality of life of these patients after neoadjuvant SRS alone.
- To assess the effect of SRS and surgical intervention on the preservation of neurocognitive functioning in these patients.
- To determine the clinical significance (mass effect, cognitive functioning, and other symptoms) of locally recurrent brain metastases at the time of their occurrence in these patients.
- To estimate the rate of death due to neurologic causes, defined as death attributable to the progression of neurological disease, in these patients.
- To estimate the overall survival of these patients.
OUTLINE: Patients undergo stereotactic radiosurgery over 30 to 90 minutes. Approximately 2-4 weeks later, patients undergo surgical resection of brain metastasis.
Quality of life and neurocognitive function are assessed periodically using the FACT-Br subscales and Mini-Mental State Exam.
After completion of study treatment, patients are followed every 3 months for 1 year and then every 6 months for 1 year.
Masking: Open Label, Primary Purpose: Treatment
cognitive assessment, neoadjuvant therapy, quality-of-life assessment, therapeutic conventional surgery, stereotactic radiosurgery
Duke Comprehensive Cancer Center
National Cancer Institute (NCI)
Published on BioPortfolio: 2014-08-27T03:25:31-0400
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