Turkish Neurosurgery
Gamma Knife Radiosurgery for Brain Metastasis from Primary Thyroid Cancer
Mehmet Ali Tepebasili1, Dogu Cihan Yildirim2, Ali Haluk Duzkalir2, Mehmet Orbay Askeroglu2, Elena Vetlova3, Valery Kostjuchenko3, Andrey Golanov3, Selcuk Peker1
1Koç University, Department of Neurosurgery, Istanbul,
2Koç University Hospital, Gamma Knife Center, Istanbul,
3Burdenko Neurosurgery Institute, Center Gamma Knife Moscow of JSC Neurosurgery Business Center, Moscow,
4Burdenko Neurosurgery Institute, Moscow,
5Russian Medical Academy of Continuous Professional Education, Moscow,
6Moscow Engineering Physics Institute, Moscow,
DOI: 10.5137/1019-5149.JTN.49225-25.1

Aim:To analyze the efficacy and safety of Gamma Knife radiosurgery (GKRS) in the management of thyroid cancer brain metastases.Material and Methods:This retrospective study analyzed patients who underwent GKRS for thyroid cancer brain metastases (TCBM) at two centers between September 2005 and February 2025. Patients clinical and radiological outcomes, including local tumor control and overall follow-up were investigated.Results:Among 3834 patients who underwent GKRS for brain metastases at two centers, only 0.26% had primary thyroid cancer. A total of 10 patients with 40 TCBM were treated by GKRS, with a median of 2 metastases per patient. The most common metastasis site was the frontal lobe (47.5%), and 60% of patients had multiple metastases. Papillary carcinoma was the most frequent histological subtype (57.1%). The median latency from thyroid cancer diagnosis to brain metastases was 22 months. The median GKRS dose was 23 Gy, and local failure occurred in 5% of treated metastases. Radiation-induced necrosis was observed in one case but resolved without clinical impact. Intracranial distant metastases were observed in two patients. The median follow-up was 8 months, and 80% of patients had died, with one death attributed to brain metastasis.Conclusion:The limited number of patients and the short follow-up period, influenced by the aggressive nature of TCBM, impact the study results. However, despite the short follow-up, GKRS provided favorable local control with no significant adverse effects, suggesting its effectiveness as a treatment option for TCBM.

Corresponding author : Selcuk Peker