J Korean Neurosurg Soc 52 | October 2012 with multiple metachronous brain metastases of lung cancer with good performance status, and that the number of the le- sions and the frequency of development of new lesions are not an obstacle in treating patients with GKRS. References 1. Aoyama H, Shirato H, Tago M, Nakagawa K, Toyoda T, Hatano K, et al. : Stereotactic radiosurgery plus whole-brain radiation therapy vs stereo- tactic radiosurgery alone for treatment of brain metastases : a random- ized controlled trial. JAMA 295 : 2483-2491, 2006 2. Aoyama H, Tago M, Kato N, Toyoda T, Kenjyo M, Hirota S, et al. : Neu- rocognitive function of patients with brain metastasis who received ei- ther whole brain radiotherapy plus stereotactic radiosurgery or radio- surgery alone. Int J Radiat Oncol Biol Phys 68 : 1388-1395, 2007 3. Auchter RM, Lamond JP, Alexander E, Buatti JM, Chappell R, Fried- man WA, et al. : A multiinstitutional outcome and prognostic factor analysis of radiosurgery for resectable single brain metastasis. Int J Ra- diat Oncol Biol Phys 35 : 27-35, 1996 4. Bahl A, Kumar M, Sharma DN, Jothy Basu KS, Jaura MS, Rath GK, et al. : Reirradiation for progressive brain metastases. J Cancer Res Ther 5 : 161-164, 2009 5. Bhatnagar AK, Flickinger JC, Kondziolka D, Lunsford LD : Stereotactic radiosurgery for four or more intracranial metastases. Int J Radiat On- col Biol Phys 64 : 898-903, 2006 6. Chang WS, Kim HY, Chang JW, Park YG, Chang JH : Analysis of radio- surgical results in patients with brain metastases according to the num- ber of brain lesions : is stereotactic radiosurgery effective for multiple brain metastases? J Neurosurg 113 : 73-78, 2010 7. Combs SE, Schulz-Ertner D, Thilmann C, Edler L, Debus J : Treatment of cerebral metastases from breast cancer with stereotactic radiosurgery. Strahlenther Onkol 180 : 590-596, 2004 8. Flickinger JC, Kondziolka D, Lunsford LD, Coffey RJ, Goodman ML, Shaw EG, et al. : A multi-institutional experience with stereotactic radio- surgery for solitary brain metastasis. Int J Radiat Oncol Biol Phys 28 : 797-802, 1994 9. Flickinger JC, Lunsford LD, Somaza S, Kondziolka D : Radiosurgery : its role in brain metastasis management. Neurosurg Clin N Am 7 : 497- 504, 1996 10. Hoffman R, Sneed PK, McDermott MW, Chang S, Lamborn KR, Park E, et al. : Radiosurgery for brain metastases from primary lung carcino- ma. Cancer J 7 : 121-131, 2001 11. Jawahar A, Willis BK, Smith DR, Ampil F, Datta R, Nanda A : Gamma knife radiosurgery for brain metastases : do patients benefit from adju- vant external-beam radiotherapy? An 18-month comparative analysis. Stereotact Funct Neurosurg 79 : 262-271, 2002 12. Joseph J, Adler JR, Cox RS, Hancock SL : Linear accelerator-based ste- reotaxic radiosurgery for brain metastases : the influence of number of lesions on survival. J Clin Oncol 14 : 1085-1092, 1996 13. Karlsson B, Hanssens P, Wolff R, Söderman M, Lindquist C, Beute G : Thirty years’ experience with Gamma Knife surgery for metastases to the brain. J Neurosurg 111 : 449-457, 2009 14. Muacevic A, Wowra B, Siefert A, Tonn JC, Steiger HJ, Kreth FW : Mi- crosurgery plus whole brain irradiation versus Gamma Knife surgery alone for treatment of single metastases to the brain : a randomized controlled multicentre phase III trial. J Neurooncol 87 : 299-307, 2008 15. Noël G, Proudhom MA, Valery CA, Cornu P, Boisserie G, Hasboun D, et al. : Radiosurgery for re-irradiation of brain metastasis : results in 54 patients. Radiother Oncol 60 : 61-67, 2001 16. Patchell RA, Tibbs PA, Regine WF, Dempsey RJ, Mohiuddin M, Kryscio RJ, et al. : Postoperative radiotherapy in the treatment of single metasta- ses to the brain : a randomized trial. JAMA 280 : 1485-1489, 1998 17. Sneed PK, Lamborn KR, Forstner JM, McDermott MW, Chang S, Park E, et al. : Radiosurgery for brain metastases : is whole brain radiotherapy necessary? Int J Radiat Oncol Biol Phys 43 : 549-558, 1999 18. Sneed PK, Suh JH, Goetsch SJ, Sanghavi SN, Chappell R, Buatti JM, et al. : A multi-institutional review of radiosurgery alone vs. radiosurgery with whole brain radiotherapy as the initial management of brain me- tastases. Int J Radiat Oncol Biol Phys 53 : 519-526, 2002 19. Varlotto JM, Flickinger JC, Niranjan A, Bhatnagar A, Kondziolka D, Lunsford LD : The impact of whole-brain radiation therapy on the long- term control and morbidity of patients surviving more than one year af- ter gamma knife radiosurgery for brain metastases. Int J Radiat Oncol Biol Phys 62 : 1125-1132, 2005 20. Wong WW, Schild SE, Sawyer TE, Shaw EG : Analysis of outcome in patients reirradiated for brain metastases. Int J Radiat Oncol Biol Phys 34 : 585-590, 1996 338