Brain Metastases from Non-small-cell Lung Carcinoma - CyberKnife Re-irradiation after Gamma Knife Radiosurgery.

Lung cancer is the most common neoplasia and the most common cause of cancer mortality. The condition is usually diagnosed at a locally advanced or metastatic stage, which is a bad prognostic factor. Around 40% of all oncology patients with brain metastases have lung cancer.Modern linear accelerators allow clinicians to perform radiosurgery and deliver a high radiation dose to low volume with a high dose gradient. Herein we present a 55-year-old male patient who received radiosurgery four times over three years - two times with Gamma Knife and two times with CyberKnife. Re-irradiation gives the opportunity to treat a local progression of a metastasis, which already has been irradiated. A series of control brain magnetic resonance imaging confirmed a good local control of treated lesions with no necrosis in surrounding healthy tissue or significant oedema. The neurological symptoms were completely controlled and the quality of life of the patient improved considerably. Radiosurgery is a prevalent, non-invasive, painless method of treatment with proven clinical results. It may be reused as long as it has clinical benefits to the patient.