During the implementation of clinical trials NCT00950001 and
NCCTG/N107C/CEC.3 on post-operative stereotactic radiosurgery into clinic, it brought us some thinking of fundamental concept in science that the local control rate and survival rate rely on the treatment of marginal region more than resection cavity. Marginal region might still contain residual cancer cell while the resection cavity contains only water fluid most time. Radiation treatment should focus more on the margin rather than the cavity, thus treating cancer rather than water.
References
[1]
Mahajan, A., Ahmed, S., McAleer, M.F., et al. (2017) Post-Operative Stereotactic Radiosurgery versus Observation for Completely Resected Brain Metastases: A Single-Centre, Randomised, Controlled, Phase 3 Trial. The Lancet Oncology, 18, 1040-1048.
https://doi.org/10.1016/S1470-2045(17)30414-X
[2]
Brown, P.D., Ballman, K.V., Cerhan, J.H., et al. (2017) Postoperative Stereotactic Radiosurgery Compared with Whole Brain Radiotherapy for Resected Metastatic Brain Disease (NCCTG N107C/CEC·3): A Multicentre, Randomised, Controlled, Phase 3 Trial. The Lancet Oncology, 18, 1049-1060.
https://doi.org/10.1016/S1470-2045(17)30441-2
[3]
Lo, S.S., Chang, E.L. and Sahgal, A. (2017) Radiosurgery for Resected Brain Metastases: A New Standard of Care? The Lancet Oncology, 18, 985-987.
https://doi.org/10.1016/S1470-2045(17)30448-5
[4]
Yue, J.B. and Yu, J.M. (2017) SRS versus WBRT for Resected Brain Metastases. The Lancet Oncology, 18, e559. https://doi.org/10.1016/S1470-2045(17)30642-3
