Early brain tumor metastasis reduction following Gamma Knife surgery

Silva, Arnaldo Neves Da; Nagayama, Kazuki; Schlesinger, David; Sheehan, Jason P.

doi:10.3171/2008.4.17537

Cited by 33 publications

(29 citation statements)

References 25 publications

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“…21,26 In addition, a reduction in tumor volume after SRS has been documented to occur in 46% of NSCLC metastases. 7 Tumor volume is known to impact neurological and cognitive functioning and is likely a more important survival factor than number of tumors.…”

Section: Discussion Survivalmentioning

confidence: 99%

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Gamma Knife radiosurgery for the management of cerebral metastases from non–small cell lung cancer

Bowden

Kano

Caparosa

et al. 2015

JNS

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L ung cancer is the most common malignancy in the world, accounting for 13% of all documented cancer cases, of which 85% are non-small cell lung cancer (NSCLC). NSCLC is often diagnosed at an advanced stage, as 56% of patients present with distant metastases. 31The 5-year survival for NSCLC is 19.3% overall but decreases to 4.1% with distant metastases. 15Intracranial metastases occur in an estimated 30%-40% of patients with NSCLC and are often identifiable at the time of primary diagnosis. 6,18,23 The presence of intracranial metastases is invariably associated with a decrease in median survival across all cancer types. 10 The median survival for a patient with NSCLC and intracranial metastases who forgoes treatment is reportedly less than 2 months. The addition of fractionated whole-brain radiation therapy (WBRT) increases survival to only 3-6 months. 4,6 Gamma Knife radiosurgery (GKRS) has proven to be a low risk and effective treatment strategy for a wide variety of patients with brain metastases. The local tumor control after SRS in NSCLC patients consistently exceeds 80% in the literature. 24,30 The utilization of SRS for NSCLC metastases has increased significantly and appropriately abbreviatioNs GKRS = Gamma Knife radiosurgery; KPS = Karnofsky Performance Scale; NSCLC = non-small cell lung cancer; RPA = recursive partitioning analysis; RTOG = Radiation Therapy Oncology Group; SRS = stereotactic radiosurgery; WBRT = whole-brain radiotherapy. obJect Non-small cell lung cancer (NSCLC) is the most frequent cancer that metastasizes to brain. Stereotactic radiosurgery (SRS) has become the management of choice for most patients with such metastatic tumors. Therefore, the authors endeavored to elucidate the survival and SRS outcomes for patients with NSCLC metastasis at their center. methods In this single-institution retrospective analysis, the authors reviewed their experience with NSCLC metastasis during a 10-year period from 2001 to 2010. Seven hundred twenty patients underwent Gamma Knife radiosurgery. A total of 1004 SRS procedures were performed, and 3143 tumors were treated. The NSCLC subtype was adenocarcinoma in 386 patients, squamous cell carcinoma in 111 patients, and large cell carcinoma in 34 patients. The median aggregate tumor volume was 4.5 cm 3 (range 0.1-88 cm 3 ). results The median survival time after diagnosis of brain metastasis from NSCLC was 12.6 months, and the median survival after SRS was 8.5 months. The 1-, 2-, and 5-year survival rates after SRS were 39%, 21%, and 10%, respectively. Postradiosurgery survival was decreased in patients treated with prior whole-brain radiation therapy compared with SRS alone (p = 0.003). Aggregate tumor volume was inversely related to survival after SRS (p < 0.001), and the histological subgroups demonstrated significant survival differences (p = 0.023). The overall local tumor control rate in the entire group was 92.8%. One hundred seventy-four patients (24%) underwent repeat SRS for new or resistant metastatic deposits. coNclusioNs Stereotactic radio...

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Section: Discussion Survivalmentioning

confidence: 99%

“…A median of 2 metastases (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] were treated at each radiosurgical procedure. The median marginal dose was 18 Gy (range 10-22 Gy) and the maximum dose was 34 Gy (range 20-50 Gy).…”

Section: Radiosurgery Techniquementioning

confidence: 99%

Gamma Knife radiosurgery for the management of cerebral metastases from non–small cell lung cancer

Bowden

Kano

Caparosa

et al. 2015

JNS

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“…Within this timeframe, studies have shown SRS to achieve a 90% radiographic lesional control rate, defined as lesions with stable or decreasing size. [6][7][8][9][10] However, transient increases in the size of up to 12% of lesions have been reported, and 9% of lesions at 4-year follow-up can be larger than they were at the time of treatment. 6,8 Lesion control rates are reported to vary by time since radiosurgery, pathology, lesion size, and treatment dose.…”

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confidence: 99%

“…[6][7][8][9][10] However, transient increases in the size of up to 12% of lesions have been reported, and 9% of lesions at 4-year follow-up can be larger than they were at the time of treatment. 6,8 Lesion control rates are reported to vary by time since radiosurgery, pathology, lesion size, and treatment dose. [10][11][12][13][14] However, no single study has looked at all of these factors during serial follow-up imaging.…”

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confidence: 99%

A Comprehensive Review of MR Imaging Changes following Radiosurgery to 500 Brain Metastases

Patel

McHugh

et al. 2011

AJNR Am J Neuroradiol

151

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“…Ильялова [31], проведение СРХГН (стереотаксическая радиохирургия гамма-ножом) позво-лило достичь стабилизации внутримозговых метастазов в 88,3% случаев, а у 93,3% больных получить паллиативный эффект в виде стабилизации или регресса неврологиче-ской симптоматики [31]. В работе Arnаldo Neves Da Silva [32] у 2 больных с метастазами РЯ до 4,1 см 3 путем облу-чения опухолей на аппарате Leksell Gamma Knife в СОД 45,8 Гр отмечено уменьшение опухолей на 15% и более.…”

Section: таблица 1 определение Rpa-класса (по Rtog 1997)unclassified

Treatment in patients with ovarian cancer metastasizing to the brain

Зайцев¹,

Новикова²,

Kirsanova³

et al. 2015

Onkol. Z. im. P.A. Gercena

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Ключевые слова: метастазы в головном мозге, внутричерепные новообразования, рак яичников.The review gives the data available in the literature on the problem in treating patients with intracranial metastases from ovarian cancer (OC). The incidence of secondary brain involvement in OC has increased 6.5-fold in the last 20 years. The optimal treatment policy for intracerebral metastases from OC remains a complicated problem. If the foci are more than 3 cm, surgical treatment followed by chemotherapy and radiotherapy is recommended. If the foci are smaller, brain stereotactic radiosurgery followed by chemotherapy is the method of choice. The authors' investigation was conducted in 8 patients with brain metastases from OC, who had undergone microsurgical removal of a metastatic brain tumor, followed by multimodality treatment. After multimodality treatment, median overall survival was 15.0 months and median relapse-free survival was 11.5 months. Metastatic brain involvement is traditionally considered as a final manifestation of the disease and characterized by an extremely pessimistic prognosis. Our experience demonstrates that combination treatment involving surgery results in prolonged survival in patients who have a satisfactory quality of life. Keywords: breast cancer, intracranial neoplasms, ovarian cancer. © Коллектив авторов, 2015Кирсанова Ольга

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Early brain tumor metastasis reduction following Gamma Knife surgery

Abstract: Gamma Knife surgery can offer patients early substantial volume reduction in many brain metastases. In instances in which early volume reduction of limited intracranial disease is desired, GKS may be used alone or before whole brain radiation therapy.

Cited by 33 publications

References 25 publications

Gamma Knife radiosurgery for the management of cerebral metastases from non–small cell lung cancer

Gamma Knife radiosurgery for the management of cerebral metastases from non–small cell lung cancer

A Comprehensive Review of MR Imaging Changes following Radiosurgery to 500 Brain Metastases

Treatment in patients with ovarian cancer metastasizing to the brain

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