Outcomes Following Gamma Knife for Metastases

Brain metastases occur in approximately 20-40% of all cancer patients, with an annual incidence of 170,000-200,000 cases, outnumbering primary brain tumors by a factor of ten to one (Gavrilovic, 2005; Posner, 1992). The management of brain metastases has evolved significantly in the past 10-20 years. These changes are attributable not only to improvements in the fields of neurosurgery and radiation oncology but also to refinements in diagnostic imaging and systemic therapy. Management of brain metastases requires a multidisciplinary approach. In this chapter, we will explore the evolving role of radiosurgery in the treatment of brain metastases and the controversies that have surrounded this promising therapeutic modality, especially in the context of evolving systemic management protocols.