Stereotactic radiosurgery as therapy for melanoma, renal carcinoma, and sarcoma brain metastases: Impact of added surgical resection and whole-brain radiotherapy
- Department of Neurosurgery, University of Utah, Salt Lake City, Utah, UT (United States)
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah, UT (United States)
- Department of Medicine, Division of Oncology, University of Utah, Salt Lake City, Utah, UT (United States)
- Department of Radiation Oncology, University of Utah, Salt Lake City, Utah, UT (United States)
- Department of Neurosurgery, University of Utah, Salt Lake City, Utah, UT (United States) and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (United States)
Purpose: Brain metastases of melanoma, renal carcinoma, and sarcoma have traditionally responded poorly to conventional treatments, including surgery and whole-brain radiotherapy (WBRT). Several studies have suggested a beneficial effect of stereotactic radiosurgery (SRS). We evaluated our institutional experience with systematic SRS in patients harboring these 'radioresistant' metastases. Methods and Materials: A total of 68 patients with brain metastases from melanoma, renal carcinoma, and sarcoma underwent SRS with or without WBRT or surgical resection. All patients had Karnofsky performance scores >70, and SRS was performed before the initiation of systemic therapy. The survival time was calculated from the diagnosis of brain metastases using the Kaplan-Meier product-limit method. Statistical significance was calculated using the log-rank test. Factors influencing survival, including surgical resection, WBRT, gender, number of SRS sessions, and histologic type, were evaluated retrospectively using Cox univariate models. Results: The overall median survival was 427 days (14.2 months), which appears superior to the results obtained with conventional WBRT. The addition of neither surgery nor WBRT to SRS provided a statistically significant increase in survival. Conclusion: Our results suggest that patients undergoing SRS for up to five cerebral metastases from 'radioresistant' tumors (melanoma, renal cell carcinoma, and sarcoma) have survival rates comparable to those in other series of more selected patients. The addition of surgical resection or WBRT did not result in improved survival in our series.
- OSTI ID:
- 20850188
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 66, Issue 4; Other Information: DOI: 10.1016/j.ijrobp.2006.05.078; PII: S0360-3016(06)02653-8; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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