Stereotactic Radiosurgery for Intraventricular Metastases: A Multicenter Study

Georgios Mantziaris; Stylianos Pikis; Zhiyuan Xu; Reed Mullen; Juan Alzate; Kenneth Bernstein; Douglas Kondziolka; Zhishuo Wei; Ajay Niranjan; L. Dade Lunsford; Roman Liscak; Jaromir May; Cheng Chia Lee; Huai Che Yang; François Louis Coupé; David Mathieu; Kimball Sheehan; Darrah Sheehan; Joshua D. Palmer; Haley K. Perlow; Selcuk Peker; Yavuz Samanci; Jennifer Peterson; Daniel M. Trifiletti; Matthew J. Shepard; Shahed Elhamdani; Rodney E. Wegner; Herwin Speckter; Wenceslao Hernandez; Ronald E. Warnick; Jason Sheehan

doi:10.1227/neu.0000000000002248

Stereotactic Radiosurgery for Intraventricular Metastases: A Multicenter Study

Georgios Mantziaris, Stylianos Pikis, Zhiyuan Xu, Reed Mullen, Juan Alzate, Kenneth Bernstein, Douglas Kondziolka, Zhishuo Wei, Ajay Niranjan, L. Dade Lunsford, Roman Liscak, Jaromir May, Cheng Chia Lee, Huai Che Yang, François Louis Coupé, David Mathieu, Kimball Sheehan, Darrah Sheehan, Joshua D. Palmer, Haley K. PerlowSelcuk Peker, Yavuz Samanci, Jennifer Peterson, Daniel M. Trifiletti, Matthew J. Shepard, Shahed Elhamdani, Rodney E. Wegner, Herwin Speckter, Wenceslao Hernandez, Ronald E. Warnick, Jason Sheehan

Radiation Oncology

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Intraventricular metastases (IVMs) are uncommon, and their optimal management remains debatable. OBJECTIVE: To define the safety and efficacy of stereotactic radiosurgery (SRS) in the treatment of IVMs. METHODS: This retrospective, multicenter study included patients managed with SRS for IVMs. SRS-induced adverse events, local tumor or intracranial progression, and the frequency of new-onset hydrocephalus or leptomeningeal spread were documented. Analyses of variables related to patient neuroimaging or clinical outcomes were also performed. RESULTS: The cohort included 160 patients from 11 centers who underwent SRS for treatment of 1045 intracranial metastases, of which 196 were IVMs. The median survival from SRS was 10 months. Of the 154 patients and 190 IVMs with imaging follow-up, 94 patients (61%) experienced distant intracranial disease progression and 16 IVMs (8.4%) progressed locally. The 12- and 24-month local IVM control rates were 91.4% and 86.1%, respectively. Sixteen (10%) and 27 (17.5%) patients developed hydrocephalus and leptomeningeal dissemination post-SRS, respectively. Adverse radiation effects were documented in 24 patients (15%). Eleven patients (6.9%) died because of intracranial disease progression. CONCLUSION: SRS is an effective treatment option for IVMs, with a local IVM control rate comparable with SRS for parenchymal brain metastases. Leptomeningeal spread and hydrocephalus in patients with IVM occur in a minority of patients, but these patients warrant careful follow-up to detect these changes.

Original language	English (US)
Pages (from-to)	565-573
Number of pages	9
Journal	Neurosurgery
Volume	92
Issue number	3
DOIs	https://doi.org/10.1227/neu.0000000000002248
State	Published - Mar 1 2023

Keywords

Brain metastases
Hydrocephalus
Intraventricular
Leptomeningeal dissemination
Stereotactic radiosurgery

ASJC Scopus subject areas

Clinical Neurology
Surgery

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10.1227/neu.0000000000002248

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Mantziaris, G., Pikis, S., Xu, Z., Mullen, R., Alzate, J., Bernstein, K., Kondziolka, D., Wei, Z., Niranjan, A., Lunsford, L. D., Liscak, R., May, J., Lee, C. C., Yang, H. C., Coupé, F. L., Mathieu, D., Sheehan, K., Sheehan, D., Palmer, J. D., ... Sheehan, J. (2023). Stereotactic Radiosurgery for Intraventricular Metastases: A Multicenter Study. Neurosurgery, 92(3), 565-573. https://doi.org/10.1227/neu.0000000000002248

Mantziaris, G, Pikis, S, Xu, Z, Mullen, R, Alzate, J, Bernstein, K, Kondziolka, D, Wei, Z, Niranjan, A, Lunsford, LD, Liscak, R, May, J, Lee, CC, Yang, HC, Coupé, FL, Mathieu, D, Sheehan, K, Sheehan, D, Palmer, JD, Perlow, HK, Peker, S, Samanci, Y, Peterson, J, Trifiletti, DM, Shepard, MJ, Elhamdani, S, Wegner, RE, Speckter, H, Hernandez, W, Warnick, RE & Sheehan, J 2023, 'Stereotactic Radiosurgery for Intraventricular Metastases: A Multicenter Study', Neurosurgery, vol. 92, no. 3, pp. 565-573. https://doi.org/10.1227/neu.0000000000002248

@article{13de60ed2fce4377886fd6aa112ae6ea,

title = "Stereotactic Radiosurgery for Intraventricular Metastases: A Multicenter Study",

abstract = "BACKGROUND: Intraventricular metastases (IVMs) are uncommon, and their optimal management remains debatable. OBJECTIVE: To define the safety and efficacy of stereotactic radiosurgery (SRS) in the treatment of IVMs. METHODS: This retrospective, multicenter study included patients managed with SRS for IVMs. SRS-induced adverse events, local tumor or intracranial progression, and the frequency of new-onset hydrocephalus or leptomeningeal spread were documented. Analyses of variables related to patient neuroimaging or clinical outcomes were also performed. RESULTS: The cohort included 160 patients from 11 centers who underwent SRS for treatment of 1045 intracranial metastases, of which 196 were IVMs. The median survival from SRS was 10 months. Of the 154 patients and 190 IVMs with imaging follow-up, 94 patients (61%) experienced distant intracranial disease progression and 16 IVMs (8.4%) progressed locally. The 12- and 24-month local IVM control rates were 91.4% and 86.1%, respectively. Sixteen (10%) and 27 (17.5%) patients developed hydrocephalus and leptomeningeal dissemination post-SRS, respectively. Adverse radiation effects were documented in 24 patients (15%). Eleven patients (6.9%) died because of intracranial disease progression. CONCLUSION: SRS is an effective treatment option for IVMs, with a local IVM control rate comparable with SRS for parenchymal brain metastases. Leptomeningeal spread and hydrocephalus in patients with IVM occur in a minority of patients, but these patients warrant careful follow-up to detect these changes.",

keywords = "Brain metastases, Hydrocephalus, Intraventricular, Leptomeningeal dissemination, Stereotactic radiosurgery",

author = "Georgios Mantziaris and Stylianos Pikis and Zhiyuan Xu and Reed Mullen and Juan Alzate and Kenneth Bernstein and Douglas Kondziolka and Zhishuo Wei and Ajay Niranjan and Lunsford, {L. Dade} and Roman Liscak and Jaromir May and Lee, {Cheng Chia} and Yang, {Huai Che} and Coup{\'e}, {Fran{\c c}ois Louis} and David Mathieu and Kimball Sheehan and Darrah Sheehan and Palmer, {Joshua D.} and Perlow, {Haley K.} and Selcuk Peker and Yavuz Samanci and Jennifer Peterson and Trifiletti, {Daniel M.} and Shepard, {Matthew J.} and Shahed Elhamdani and Wegner, {Rodney E.} and Herwin Speckter and Wenceslao Hernandez and Warnick, {Ronald E.} and Jason Sheehan",

year = "2023",

month = mar,

day = "1",

doi = "10.1227/neu.0000000000002248",

language = "English (US)",

volume = "92",

pages = "565--573",

journal = "Neurosurgery",

issn = "0148-396X",

publisher = "Lippincott Williams and Wilkins",

number = "3",

}

TY - JOUR

T1 - Stereotactic Radiosurgery for Intraventricular Metastases

T2 - A Multicenter Study

AU - Mantziaris, Georgios

AU - Pikis, Stylianos

AU - Xu, Zhiyuan

AU - Mullen, Reed

AU - Alzate, Juan

AU - Bernstein, Kenneth

AU - Kondziolka, Douglas

AU - Wei, Zhishuo

AU - Niranjan, Ajay

AU - Lunsford, L. Dade

AU - Liscak, Roman

AU - May, Jaromir

AU - Lee, Cheng Chia

AU - Yang, Huai Che

AU - Coupé, François Louis

AU - Mathieu, David

AU - Sheehan, Kimball

AU - Sheehan, Darrah

AU - Palmer, Joshua D.

AU - Perlow, Haley K.

AU - Peker, Selcuk

AU - Samanci, Yavuz

AU - Peterson, Jennifer

AU - Trifiletti, Daniel M.

AU - Shepard, Matthew J.

AU - Elhamdani, Shahed

AU - Wegner, Rodney E.

AU - Speckter, Herwin

AU - Hernandez, Wenceslao

AU - Warnick, Ronald E.

AU - Sheehan, Jason

PY - 2023/3/1

Y1 - 2023/3/1

N2 - BACKGROUND: Intraventricular metastases (IVMs) are uncommon, and their optimal management remains debatable. OBJECTIVE: To define the safety and efficacy of stereotactic radiosurgery (SRS) in the treatment of IVMs. METHODS: This retrospective, multicenter study included patients managed with SRS for IVMs. SRS-induced adverse events, local tumor or intracranial progression, and the frequency of new-onset hydrocephalus or leptomeningeal spread were documented. Analyses of variables related to patient neuroimaging or clinical outcomes were also performed. RESULTS: The cohort included 160 patients from 11 centers who underwent SRS for treatment of 1045 intracranial metastases, of which 196 were IVMs. The median survival from SRS was 10 months. Of the 154 patients and 190 IVMs with imaging follow-up, 94 patients (61%) experienced distant intracranial disease progression and 16 IVMs (8.4%) progressed locally. The 12- and 24-month local IVM control rates were 91.4% and 86.1%, respectively. Sixteen (10%) and 27 (17.5%) patients developed hydrocephalus and leptomeningeal dissemination post-SRS, respectively. Adverse radiation effects were documented in 24 patients (15%). Eleven patients (6.9%) died because of intracranial disease progression. CONCLUSION: SRS is an effective treatment option for IVMs, with a local IVM control rate comparable with SRS for parenchymal brain metastases. Leptomeningeal spread and hydrocephalus in patients with IVM occur in a minority of patients, but these patients warrant careful follow-up to detect these changes.

AB - BACKGROUND: Intraventricular metastases (IVMs) are uncommon, and their optimal management remains debatable. OBJECTIVE: To define the safety and efficacy of stereotactic radiosurgery (SRS) in the treatment of IVMs. METHODS: This retrospective, multicenter study included patients managed with SRS for IVMs. SRS-induced adverse events, local tumor or intracranial progression, and the frequency of new-onset hydrocephalus or leptomeningeal spread were documented. Analyses of variables related to patient neuroimaging or clinical outcomes were also performed. RESULTS: The cohort included 160 patients from 11 centers who underwent SRS for treatment of 1045 intracranial metastases, of which 196 were IVMs. The median survival from SRS was 10 months. Of the 154 patients and 190 IVMs with imaging follow-up, 94 patients (61%) experienced distant intracranial disease progression and 16 IVMs (8.4%) progressed locally. The 12- and 24-month local IVM control rates were 91.4% and 86.1%, respectively. Sixteen (10%) and 27 (17.5%) patients developed hydrocephalus and leptomeningeal dissemination post-SRS, respectively. Adverse radiation effects were documented in 24 patients (15%). Eleven patients (6.9%) died because of intracranial disease progression. CONCLUSION: SRS is an effective treatment option for IVMs, with a local IVM control rate comparable with SRS for parenchymal brain metastases. Leptomeningeal spread and hydrocephalus in patients with IVM occur in a minority of patients, but these patients warrant careful follow-up to detect these changes.

KW - Brain metastases

KW - Hydrocephalus

KW - Intraventricular

KW - Leptomeningeal dissemination

KW - Stereotactic radiosurgery

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U2 - 10.1227/neu.0000000000002248

DO - 10.1227/neu.0000000000002248

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AN - SCOPUS:85148250220

SN - 0148-396X

VL - 92

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EP - 573

JO - Neurosurgery

JF - Neurosurgery

IS - 3

ER -

Stereotactic Radiosurgery for Intraventricular Metastases: A Multicenter Study

Abstract

Keywords

ASJC Scopus subject areas

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