Stereotactic radiosurgery for patients with brain metastases from nasopharyngeal carcinoma.

PURPOSE

The role of stereotactic radiosurgery (SRS) for patients with brain metastases from nasopharyngeal carcinoma (NPC) has yet to be established. The authors present a single-institution experience of NPC brain metastases patients who underwent SRS.

METHODS

Our SRS database of 18,000 patients from 1989 to 2024 identified 44 metastatic NPC patients (31 male) with 68 total brain metastases (median age: 58.5 years, range: 33-80). Twenty-four patients underwent whole brain fractionated radiation therapy (WBRT) and 20 patients underwent surgical resection before SRS. The median margin dose was 16 Gy (range: 10-25). The median cumulative tumor volume was 7.6 cubic centimeters (cc) (range: 0.032-186.66).

RESULTS

The median overall survival (OS) from SRS was 9 months (range: 0-86) with local tumor progression in 11 patients after SRS at a median time of 4 months (range: 2-36). Local tumor control was achieved in 56 of the 68 metastases (82.4%). Five patients developed new brain metastases at a median of 6 months (range: 3-84) following SRS. One patient experienced adverse radiation effects (AREs).

CONCLUSION

Metastatic spread to the brain from NPC occurs late in the course of primary disease. In our experience non-invasive SRS optimized outcomes and preserved quality of life. Although historically used as a salvage option after surgery and radiation therapy, its role as a primary strategy deserves further utilization in patients with brain metastases from primary NPC tumors.