• Fred Hsu, Para Kouhestani, Sonia Nguyen, Arthur Cheung, Michael McKenzie, Roy Ma, Brian Toyota, and Alan Nichol.
• Abbotsford Centre, BC Cancer Agency, British Columbia, Canada. fhsu@bccancer.bc.ca
• Radiother Oncol. 2013 Jul 1; 108 (1): 128-31.

PurposeWe conducted a retrospective population-based study to examine the survival outcomes in patients with brain metastases treated with salvage stereotactic radiosurgery (SRS), compared to boost SRS, after previous whole brain radiotherapy (WBRT).Methods And MaterialsFrom January 2000 to June 2011, 191 patients treated with WBRT and SRS for brain metastases in British Columbia were studied. Patients were divided into a boost cohort and a salvage cohort. The criteria used to determine eligibility for SRS were: 1-3 metastases, ≤4cm size, Karnofsky performance status ≥ 70, and control of extracranial disease.ResultsDiagnosis by primary site was 84 lung, 47 breast, 15 melanoma, 12 renal, 9 colorectal, and 24 other. There were 113 patients (59%) in the boost cohort and 78 patients (41%) in the salvage cohort. The median overall survival from WBRT for the whole population was 17.7months: 12.1 months for the boost cohort and 22.7 months for the salvage cohort. There was no difference in median survival after SRS for the boost and salvage cohorts (11.2 vs. 11.2 months, p=0.78).ConclusionsIn selected patients with brain metastases treated with WBRT, survival following salvage SRS is as good as survival after WBRT + boost SRS.Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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