March 2017 | Volume 7 | Article 32 1 ORIGINAL RESEARCH published: 09 March 2017 doi: 10.3389/fonc.2017.00032 Frontiers in Oncology | www.frontiersin.org Edited by: Sean P. Collins, Georgetown University School of Medicine, USA Reviewed by: Shahed Nicolas Badiyan, University of Maryland Medical Center, USA John Austin Vargo, University of Pittsburgh, USA *Correspondence: Rachelle Lanciano rlancmd@gmail.com Specialty section: This article was submitted to Radiation Oncology, a section of the journal Frontiers in Oncology Received: 24 December 2016 Accepted: 24 February 2017 Published: 09 March 2017 Citation: Ahmad S, Ricco A, Brown R, Hanlon A, Yang J, Feng J, Stanley M, Buonocore R, Okpaku A, Arrigo S, Lamond J, Brady L and Lanciano R (2017) Single Institutional Experience of Stereotactic Radiosurgery Alone for First Brain Metastatic Event and Salvage of Second Brain Metastatic Event in a Community Setting with Review of the Literature. Front. Oncol. 7:32. doi: 10.3389/fonc.2017.00032 Single Institutional Experience of Stereotactic Radiosurgery Alone for First Brain Metastatic Event and Salvage of Second Brain Metastatic Event in a Community Setting with Review of the Literature Shaharyar Ahmad 1 , Anthony Ricco 2 , Royce Brown 2 , Alexandra Hanlon 3 , Jun Yang 1,2 , Jing Feng 2 , Michael Stanley 2 , Richard Buonocore 2 , Aubrey Okpaku 2 , Steven Arrigo 2 , John Lamond 1,2 , Luther Brady 1,2 and Rachelle Lanciano 1,2 * 1 Drexel University College of Medicine, Philadelphia, PA, USA, 2 Philadelphia Cyberknife, Crozer-Keystone Health Care System, Havertown, PA, USA, 3 University of Pennsylvania, Philadelphia, PA, USA Purpose: To document survival for patients treated with stereotactic radiosurgery (SRS) alone for brain metastases either at initial presentation or for salvage in conjunction with other known prognostic factors in a single institutional community setting with compar- ison to current literature. Methods: All patients treated for brain metastases with SRS between October 2006 and October 2013 were reviewed. We identifed 91 patients treated with SRS alone for frst brain metastatic event (FBME) and 87 patients treated with SRS for second brain metastatic event (SBME). We excluded the 14 patients treated with SRS for both FBME and SBME to satisfy the independence assumption for comparison of groups. Patient demographics, including age, gender, primary cancer type, presence of extracranial metastases, number of brain metastases, initial site of metastases (brain vs. other), recursive partitioning analysis (RPA), and Karnofsky Performance status (KPS) were documented. Results: There were no signifcant differences in overall survival for patients treated with SRS for FBME compared with SBME (log-rank p = 0.9347). Univariate and multivariable Cox regression modeling revealed KPS (p = 0.0003) and RPA (p = 0.0143) were the only independent prognostic factors for survival. Specifcally, patients with RPA 1 had a 61% decreased risk of death compared to those with RPA 3. Patients with RPA 2 had a 33% decreased risk of death compared to those with RPA 3. The 1-year survival rate was 36.5% for patients with RPA1, 33.3% for those with RPA 2, and 17.1% for those with RPA 3. Patients with KPS 90–100 had a 62% decreased risk of death compared to those with KPS < 70. The 1-year survival rate for patients KPS 90–100, 70–80, and <70 were 60.7, 24.6, and 16.7%, respectively.