The NCCTG N107C/CEC.3 trial randomised 194 patients with one resected BM to post-operative SRS or WBRT.r Post-operative SRS showed a longer cognitive deterioration free survival (median 3.7 months, 95% CI: 3.45-5.06) compared to WBRT (median 3 months, 95% CI: 2.86-3.25). Cognitive deterioration at 6 months was less frequent in patients who received post- operative SRS (52%) with WBRT (85%) (difference -33.6%, 95% CI: -45.3 to -21.8, P<0.00031).
Mahajan et al. (2017) randomised 132 patients with one to three BM to post-operative SRS or observation alone.r Post-operative SRS showed an improved 12-month local tumour recurrence free rate (72%, 95% CI: 60%-87%) compared to observation (43%, 95% CI: 31%-59%).
Brennan et al. (2014) treated 29 patients following surgical resection with SRS prospectively.r They reported a local control rate of 85% at 12 months. Larger tumour diameter (>3 cm) was associated with increased local failure. NSCLC histology was found to be associated with a decreased risk of local failure compared to brain metastasis from other primaries (14% vs 32%, HR= 0.34, p=0.048).
Soltys et al. (2008) retrospectively evaluated 72 patients following surgical resection, and were treated with SRS to the tumour bed.r Local control rates were 88% at 6 months and 79% at 12 months.