Journal article
Stereotactic Radiosurgery With or Without Whole Brain Radiotherapy for Patients With a Single Radioresistant Brain Metastasis
American journal of clinical oncology, v 33(1), pp 70-74
Feb 2010
PMID: 19652578
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose: To examine the outcomes of patients with a single brain metastasis from radioresistant histologies (renal cell carcinoma and melanoma) treated with stereotactic radiosurgery (SRS) with or without whole brain radiotherapy WBRT.
Methods and Materials: We reviewed the medical records of 27 patients treated at our institution between 2000 and 2007 with a single radioresistant brain metastasis. Patients were treated with Gamma Knife based SRS. Tumor histologies included renal cell carcinoma and melanoma.
Results: Patients were treated to a median marginal dose was 20 Gy (range, 15-22 Gy). At follow-up intervals ranging from 1.8 to 23.2 months, the radiographic responses were as follows: progression in 7 patients stable in 5 patients; and shrinkage in 15 patients. Fifteen patients (56%) developed distant brain failure. Seven of the 27 patients were alive at last follow-up.The 3-, 6- 9-, 12-, and 18-months after SRS local control rates were 82.8%, 77.9%, 69.3%, 69.3%, and 55.4%, respectively. None of the 5 patients who received WBRT developed distant brain failure although file follow-up intervals were short (range, 3.5-13.7 months; median. 5.1 months). WBRT did not appear to affect local control, progression free survival, and overall survival (P = 0.32, 0.87, 0.69). One patient developed worsening of symptoms attributable to SRS.
Conclusions: Gamma Knife SRS is a safe and feasible strategy for treatment of patients with a single radioresistant brain metastasis. Radiosurgery alone is a reasonable treatment option, but may carry a greater likelihood of distant brain recurrence.
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Details
- Title
- Stereotactic Radiosurgery With or Without Whole Brain Radiotherapy for Patients With a Single Radioresistant Brain Metastasis
- Creators
- James W. Clarke - The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research InstituteSteven Register - The University of Texas MD Anderson Cancer CenterJohn M. McGregor - The Ohio State UniversityJohn C. Grecula - The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research InstituteNina A. Mayr - The Ohio State UniversityJian Z. Wang - The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research InstituteKaile Li - The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research InstituteNilendu Gupta - The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research InstituteKari L. Kendra - The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research InstituteThomas E. Olencki - The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research InstituteRobert CavaliereAtom Sarkar - The Ohio State UniversitySimon S. Lo - The Ohio State University
- Publication Details
- American journal of clinical oncology, v 33(1), pp 70-74
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 5
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology; Neurosurgery
- Web of Science ID
- WOS:000274413500014
- Scopus ID
- 2-s2.0-76749163258
- Other Identifier
- 991021960814104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology