Radiosurgery for solitary brain metastases using the cobalt-60 gamma unit: methods and results in 24 patients

Journal Article · Sat Jun 01 04:00:00 EDT 1991 · International Journal of Radiation Oncology, Biology and Physics; (United States)

DOI:https://doi.org/10.1016/0360-3016(91)90240-5· OSTI ID:5554862

Coffey, R J; Flickinger, J C; Bissonette, D J; Lunsford, L D ^[1]

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1. Department of Neurosurgery, Mayo Clinic, Rochester, MN (USA)

To define the role of stereotactic radiosurgery in the treatment of metastatic brain tumors we treated 24 consecutive patients (20 men, 4 women) with the 201-source 60Co gamma unit between May 1988 and March 1990. The primary tumors included malignant melanoma (n = 10), non-small cell lung carcinoma (n = 6), renal cell carcinoma (n = 3), colorectal carcinoma (n = 1), oropharyngeal carcinoma (n = 1), and adenocarcinoma of unknown origin (n = 3). All tumors were less than or equal to 3.0 cm in greatest diameter. Twenty patients received a planned combination of 30-40 Gy whole brain fractionated irradiation and a radiosurgical boost of 16-20 Gy to the tumor margins; one patient refused conventional fractionated irradiation. Three patients with recurrent, persistent, or new non-small cell lung carcinomas had radiosurgical treatment 12-20 months after receiving 30-42.5 Gy whole-brain external beam irradiation. Stereotactic computed tomographic imaging was used for target coordinate determination and imaging-integrated dose planning. All tumors were enclosed by the 50-90% isodose shell using one (n = 22), two (n = 1), or three (n = 1) irradiation isocenters. During this 23-month period (median follow-up of 7 months) no patient died from progression of a radiosurgically-treated brain metastasis. Ten patients died of systemic disease (n = 8) or remote central nervous system metastasis (n = 2) between 1 week and 10 months after radiosurgery. One patient had tumor progression and underwent craniotomy and tumor excision 5 months after radiosurgery. To date, median survival after radiosurgery has been 10 months; 1-year survival was 33.3%. Stereotactic radiosurgery eliminated the surgical and anesthetic risks associated with craniotomy and resection of solitary brain metastases.

• OSTI ID: 5554862
• Journal Information: International Journal of Radiation Oncology, Biology and Physics; (United States), Journal Name: International Journal of Radiation Oncology, Biology and Physics; (United States) Vol. 20:6; ISSN IOBPD; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

550603* -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BODY
BRAIN
CARCINOMAS
CENTRAL NERVOUS SYSTEM
COBALT 60
COBALT ISOTOPES
DIGESTIVE SYSTEM
DISEASES
ELECTROMAGNETIC RADIATION
FRACTIONATED IRRADIATION
GAMMA RADIATION
GASTROINTESTINAL TRACT
INTERMEDIATE MASS NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
INTESTINES
IONIZING RADIATIONS
IRRADIATION
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
KIDNEYS
LARGE INTESTINE
LUNGS
MEDICINE
MELANOMAS
METASTASES
MINUTES LIVING RADIOISOTOPES
NEOPLASMS
NERVOUS SYSTEM
NUCLEAR MEDICINE
NUCLEI
ODD-ODD NUCLEI
ORGANS
PATIENTS
PHARYNX
RADIATIONS
RADIOISOTOPES
RADIOLOGY
RADIOTHERAPY
RECTUM
RESPIRATORY SYSTEM
SURVIVAL CURVES
THERAPY
YEARS LIVING RADIOISOT