Brain metastases are a condition when cancer cells spread from their original site to the brain. More than 10-30% of adults with cancer suffer from brain metastases, resulting in severe morbidity. Stereotactic radiosurgery (SRS) and surgical resection are two routinely used methods for local control of brain metastasis. This study aims to compare the efficacy of local control of brain metastases in patients treated with SRS and surgical resection.

This exploratory analysis of the EORTC 22952-26001clinical trial included a total of 268 patients with 1 to 3 brain metastases. The patients were randomized to SRS (154) or surgical resection (114), followed by whole-brain radiotherapy or observation. The primary outcome of the study was the local recurrence of the treated lesions.

Patients who underwent surgical resection had larger metastases when compared with those in the SRS group. Those who underwent surgical resection more frequently had 1 brain metastasis (98.2% vs. 74.0%) and different in location (18.4% vs. 39.6%) and posterior fossa (26.3% vs. 7.8%) than the SRS group. Multivariable adjustment indicated a similar local recurrence between the two groups; however, the risk of early local recurrence was higher in those who underwent surgical resection. 

The research concluded that both SRS and surgical resection resulted in similar local control of brain metastases, though SRS had improved early outcomes.