Gamma Knife Radiosurgery for the Treatment of Brain Metastases

Sansur, Charles A.; Chin, Lawrence S.; Ames, JW; Banegura, Allen T.; Aggarwal, Sudarshan K.; Ballesteros, María; Amin, Pradip; Simard, Joyce; Eisenberg, Howard M.

doi:10.1159/000056462

Cited by 41 publications

(7 citation statements)

References 19 publications

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“…The rise in use of this technique is attributable to minimal invasiveness, a substantial reduction in hos- pitalization time and cost, an excellent local tumor control rate (even in putatively radioresistant oncotypes), and a very low associated morbidity 16,22) . Moreover, although there have been no direct randomized clinical comparisons of GKRS with other surgical-radiation protocols, the results of GKRS in patients with solitary lesions were similar or superior to those obtained using other methods 8,13,15,17,19) .…”

Section: Discussionmentioning

confidence: 99%

Gamma Knife Radiosurgery after Stereotactic Aspiration for Large Cystic Brain Metastases

Park

Jang

Kim

et al. 2009

J Korean Neurosurg Soc

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Objective : Several treatment options have proven effective for metastatic brain tumors, including surgery and stereotactic radiosurgery. Tumors with cystic components, however, are difficult to treat using a single method. We retrospectively assessed the outcome and efficacy of gamma knife radiosurgery (GKRS) for cystic brain metastases after stereotactic aspiration of cystic components to decrease the tumor volume. Methods : The study population consisted of 24 patients (13 males, 11 females; mean age, 58.3 years) with cystic metastatic brain tumors treated from January 2002 to August 2008. Non-small cell lung cancer was the most common primary origin. After Leksell stereotactic frame was positioned on each patient, magnetic resonance images (MRI)-guided stereotactic cyst aspiration and GKRS were performed (mean prescription dose : 20.2 Gy). After treatment, patients were evaluated by MRI every 3 or 4 months. Results : After treatment, 13 patients (54.2%) demonstrated tumor control, 5 patients (20.8%) showed local tumor progression, and 6 patients (25.0%) showed remote progression. Mean follow-up duration was 13.1 months. During this period, 10 patients (41.7%) died, but only 1 patient (4.2%) died from brain metastases. The overall median survival after these procedures was 17.8 months. Conclusion : These results support the usefulness of GKRS after stereotactic cyst aspiration in patients with large cystic brain metastases. This method is especially effective for the patients whose general condition is very poor for general anesthesia and those with metastatic brain tumors located in eloquent areas.

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Section: Discussionmentioning

confidence: 99%

Gamma Knife Radiosurgery after Stereotactic Aspiration for Large Cystic Brain Metastases

Park

Jang

Kim

et al. 2009

J Korean Neurosurg Soc

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“…Photon beam ''gamma knife'' radiosurgical techniques have been used with a high tumor control rate, low morbidity and mortality, giving a median survival of 9 to 10 months [34][35][36]. The role of adjuvant gamma knife therapy following resection is unknown.…”

Section: Brain and Spinal Cordmentioning

confidence: 99%

The role of surgery in treatment of stage IV melanoma

Young

Martinez

Essner

2006

Journal of Surgical Oncology

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The prognosis for patients with melanoma has not improved over the last 30 years. So far, almost without exception, clinical trials conducted with single or multiple agent chemotherapy, biological therapy (interferon-alpha, interleukin-2), and biochemotherapy have failed to demonstrate consistent survival benefit. Without effective alternate treatments, surgery must be considered the primary treatment of melanoma, independent of disease stage. Although surgery is clearly favored as the treatment of localized melanoma, consensus opinion and clinician preference become divided once melanoma progresses beyond its primary site. Many physicians will adopt an attitude of resignation and hesitancy when treating metastatic melanoma. As a result, patients with advanced disease are often treated with medications that produce little survival or palliative benefit at the expense of significant toxicity. Numerous studies have demonstrated clear and durable survival advantages for patients undergoing complete resection of metastatic melanoma. Further, surgical resection can produce an immediate decrease in tumor burden with minimal morbidity and mortality at a reasonable cost.

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“…With stereotactic radiation (gamma knife), high single doses in the range of 20 Gy are delivered to tumor cell deposits. This is much more effective at tumor destruction, but 20–25% of patients have tumors that fail to be controlled even after that large a dose of radiation [ 36 , 37 ]. Thus, there is ample evidence from clinical experience that high doses of gamma radiation may be inadequate to prevent human tumor cells from proliferating.…”

Section: Discussionmentioning

confidence: 99%

The use of gamma-irradiation and ultraviolet-irradiation in the preparation of human melanoma cells for use in autologous whole-cell vaccines

et al. 2008

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Background: Human cancer vaccines incorporating autologous tumor cells carry a risk of implantation and subsequent metastasis of viable tumor cells into the patient who is being treated. Despite the fact that the melanoma cell preparations used in a recent vaccine trial (Mel37) were gamma-irradiated (200 Gy), approximately 25% of the preparations failed quality control release criteria which required that the irradiated cells incorporate 3 H-thymidine at no more than 5% the level seen in the non-irradiated cells. We have, therefore, investigated ultraviolet (UV)-irradiation as a possible adjunct to, or replacement for gamma-irradiation.

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Gamma Knife Radiosurgery for the Treatment of Brain Metastases

Cited by 41 publications

References 19 publications

Gamma Knife Radiosurgery after Stereotactic Aspiration for Large Cystic Brain Metastases

Gamma Knife Radiosurgery after Stereotactic Aspiration for Large Cystic Brain Metastases

The role of surgery in treatment of stage IV melanoma

The use of gamma-irradiation and ultraviolet-irradiation in the preparation of human melanoma cells for use in autologous whole-cell vaccines

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