Re-irradiation of multiple brain metastases using CyberKnife stereotactic radiotherapy: Case report

Abstract

Introduction:Brain metastasis (BM) is the commonest adult intracranial malignancy and many patients with brain metastases require two course radiotherapy. Re-irradiation is frequently performed in Radiotherapy (RT) departments for multiple brain metastases.Patient concerns:We present a case of a 55-year-old male patient suffering from brain metastases, who had previously received whole-brain radiotherapy (WBRT) and first CyberKnife Stereotactic Radiotherapy (CKSRT) for metastases, presented with a recurrence of metastasis and new lesions in the brain.Diagnoses:An enhanced computed tomography (CT) scan of the brain revealed abnormalities with double-dosing of intravenous contrast that identified >10 lesions scattered in the whole brain.Interventions:Re-irradiation was performed using CKSRT. The patient was treated with 30-Gy in 5 fractions for new lesions and 25-Gy in 5 fractions for lesion that were locally recurrent and close to brainstem lesions.Outcome:The lesions were well-controlled, and the headache of the patient was significantly relieved one month after radiotherapy. The total survival time of the patients was 17-months from the beginning of the Cyberknife treatment.Conclusion:The present case report demonstrates that CyberKnife therapy plays a significant role in the repeated radiotherapy for multiple metastatic brain tumors. CKSRT can be used as a salvage method in recurrent multiple brain metastases.