OBJECTIVE: To identify a size cutoff below which it is safe to observe obscure @entity75 suspected of being metastases so that treatment of nonmetastases can be avoided. METHODS: Medical records from @entity1 who underwent linear accelerator-based radiosurgery from August 1991 to October 2001 were reviewed. Inclusion criteria were defined as @entity75 @entity5 volume less than 5 cm(3) (diameter, thick similar 2.1 cm) treated with a dose of 20 Gy or more. One hundred thirty-five @entity1 had 153 evaluable brain metastases with follow-up imaging that met inclusion criteria. Median age was 54 years (range, 18-79 yr). Lesion primaries were non-small-cell lung (n = 39), @entity320 (n = 44), renal (n = 37), breast (n = 18), colon (n = 3), @entity242 (n = 5), other (n = 5), and unknown primary (n = 2). Median @entity5 volume was 0.67 cm(3) (range, 0.06-4.58 cm(3)). The minimum peripheral dose was 20 Gy (n = 132) or 21 to 24 Gy (n = 21). At the time of analysis, the median follow-up for all @entity1 was 10 months (range, 0.2-99 mo). RESULTS: The 1- and 2-year actuarial local control rates for all of the lesions were 69 and 46%, respectively. For lesions of 1 cm (0.5 cm(3)) or less, the corresponding local control rates were 86 and 78%, respectively, which was significantly higher than the corresponding rates of 56 and 24%, respectively, for lesions larger than 1 cm (0.5 cm(3)) (P = 0.0016). CONCLUSION: A convincing @entity75 measuring less than 1 cm should be pursued aggressively. If the suspected @entity75 is ambiguous, observation is proposed up to a diameter of 1 cm. This is the first study in the literature to identify a 1-cm cutoff for radiosurgical control of small brain metastases, and validation by additional studies is required.

The role of @entity5 size in the radiosurgical management of XXXX with ambiguous brain metastases.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity242 :: ('MESH:D012509', 'Disease') :: ['sarcoma'] @entity75 :: ('MESH:D001927', 'Disease') :: ['brain lesions', 'brain metastasis'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity320 :: ('MESH:D008545', 'Disease') :: ['melanoma']
@entity1 :: (9606,Species) :: ['patients']
