The role of stereotactic radiosurgery in the management of secondary pontine tumors

Abstract

Brainstem metastasis is an uncommon complication of systemic cancer and is generally considered to have a highly unfavorable prognosis. Regarding its management, stereotactic radiosurgery (SRS) is nowadays used as a feasible treatment option and is expected to achieve a radical cure. The pons is the commonest location of brainstem metastases (primarily from lung cancer), with a frequency ranging from 51.9% to 79.3%. The purpose of this review is to explore the role of radiosurgery in the management of pontine metastases. Methodologically, a combined PubMed search was mainly applied for the terms “radiosurgery” and “pontine metastases”. Beside other treatment efforts, SRS has a major role in the management of patients with secondary pontine tumors, as a safe and effective treatment option that prolongs survival with low complications rate. The mean dose used for this purpose is approximately 17 Gy and the achieved median survival of the treated patients is nearly 9 months. Although larger lesions as well as melanoma and renal cancer usually have a worse prognosis, the patient’s clinical status seems to be more important in determining survival. SRS is currently a principal treatment option for patients suffering from pontine metastases.