Bindal later found in 1996 that surgery was clearly superior to radiosurgery. The Metastatic Brain Tumor Program advocates microsurgical excision of surgically accessible brain metastases. Utilizing state of the art technology such as the ISG frameless stereotactic wand, small craniotomies can be made directly over lesions. The ISG wand can then assist the surgeon in finding the lesion while leaving surrounding normal brain unharmed. Multiple focused craniotomies can be performed at one time because current technology and microsurgical technique minimizes brain trauma.
Radiation therapy is used as a surgical adjunct.
Radiosurgery delivers focused radiation to the tumor only and spares normal brain. Because the whole brain receives minimal doses of radiation, the procedure may be repeated multiple times without risk of dementia. Chemotherapeutic agents have shown limited efficacy in treating some types of brain metastases. We reserve chemotherapy for selected cases where systemic chemotherapy is needed. The Metastatic Brain Tumor Program participates in a Phase II trial with intra-arterial carboplatinum.