Pichardo-Rojas Pavel S, Hajikarimloo Bardia, Sheehan Jason P
Vivian L. Smith Department of Neurosurgery, University of Texas Health Science Center at Houston, Texas, USA.
Department of Neurological Surgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA.
J Neurooncol. 2025 Nov;175(2):469-470. doi: 10.1007/s11060-025-05153-3. Epub 2025 Jul 21.
Häni et al. present an important analysis evaluating outcomes following resection of eloquent brain metastases without surgical margins in the context of postoperative stereotactic radiotherapy. While their findings support functional preservation without compromising local control, we believe several clinical nuances warrant further discussion. In this letter, we address the heterogeneity of tumor histologies, highlight the potential of upfront SRS in select small, eloquent lesions, and draw parallels to established strategies in benign intracranial tumors. These considerations may help refine treatment paradigms for patients with eloquent brain metastases.
哈尼等人进行了一项重要分析，评估在术后立体定向放射治疗背景下切除无手术切缘的功能区脑转移瘤后的结果。虽然他们的研究结果支持在不影响局部控制的情况下保留功能，但我们认为一些临床细微差别值得进一步讨论。在这封信中，我们讨论了肿瘤组织学的异质性，强调了对于某些小的、位于功能区的病灶先行立体定向放射外科治疗（SRS）的潜力，并将其与颅内良性肿瘤的既定策略进行比较。这些考虑因素可能有助于完善功能区脑转移瘤患者的治疗模式。
