Phase II Trial of Radiosurgery for One to Three Newly Diagnosed Brain Metastases From Renal Cell Carcinoma, Melanoma, and Sarcoma: An Eastern Cooperative Oncology Group Study (E 6397)

Mañon, R.; O’Neill, Anne; Knisely, Jonathan; Werner‐Wasik, Maria; Lazarus, Hillard M.; Wagner, Henry; Gilbert, Mark R.; Mehta, Minesh P.

doi:10.1200/jco.2005.01.8747

Cited by 172 publications

(92 citation statements)

References 27 publications

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“…[4][5][6] The standard treatment for patients with symptomatic brain metastasis and active extracranial metastases consists of whole-brain RT (WBRT) in combination with corticosteroids that, nonetheless, is barely effective (the median survival is about 3, and most treated patients dye of neurologic disease). 1,2,[7][8][9] In fact, the objective response rate of symptomatic brain metastasis from melanoma to conventional WBRT probably is not greater than 15% 7,10 ; and, for the majority of patients, the burden of such treatment may have more negative impact on the quality of life than the doubtful benefit to survival compared with corticosteroids and other supportive measures.…”

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confidence: 99%

Temozolomide in advanced malignant melanoma with small brain metastases

Boogerd

Gast

Dalesio

2007

Cancer

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BACKGROUND.The efficacy of radiotherapy (RT) in patients who have brain metastases from melanoma is limited. In this study, the authors evaluated the efficacy of treatment with temozolomide in patients with metastatic melanoma, including small brain metastases, who did not require immediate RT and investigated the feasibility of deferring RT.METHODS.Patients with brain metastasis were identified from 3 prospective studies of temozolomide (with or without immunotherapy) for metastatic melanoma. Patients with brain metastasis that measured >2 cm, extensive edema, and localization in the brain stem were excluded from the study. For the current analysis, patients with leptomeningeal metastasis and patients who received previous stereotactic RT were excluded. In patients who achieved a systemic response or stabilization to temozolomide, the response of brain metastasis and the necessity for palliative cranial RT were evaluated.RESULTS.Among 179 patients who received temozolomide for advanced melanoma, 52 patients with brain metastasis were evaluable. Stabilization of systemic metastasis was noted in 7 of 52 patients (13%), and there were 6 responses (5 partial responses and 1 complete response; 11%); thus, in those 13 patients, 6 had stabilization of brain metastasis (11%) and 5 had a response (2 partial responses and 3 complete responses; 9%). Immunotherapy did not influence the neurologic response. The median time to neurologic progression was 7 months (range 2–15, months). RT for cerebral recurrence was required in 2 patients. The median survival of patients with brain metastases was 5.6 months (95% confidence interval, 4.4–6.8 months). Intracranial hemorrhagic complications were not observed.CONCLUSIONS.The current results indicated that it is feasible to treat patients who have advanced melanoma and small brain metastasis with temozolomide as the single treatment. The small subset of patients with systemic response usually showed durable stabilization or a response of brain metastasis. With this approach, neurologic disease can be controlled, and cranial irradiation may be deferred and even withheld in most of patients. Cancer 2007. © 2006 American Cancer Society.

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Temozolomide in advanced malignant melanoma with small brain metastases

Boogerd

Gast

Dalesio

2007

Cancer

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“…В исследовании ECOG [42] было включено 36 пациентов с 1-3 гистологически радиорезистентными метастазами (почечно-клеточ-ный рак, меланома, саркома). Частота развития вну-тричерепных рецидивов составила 48 % через 6 мес после проведения СРХ как самостоятельного метода.…”

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The History of Stereotactic Radiosurgery Development and Its Role in the Treatment of Brain Metastases

Энгел¹,

Nazarenko²

2015

Opuholi golovy šei

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Обзор литературыИстория развития стереотаксической радиохирургии и ее роль в лечении метастазов в головной мозг О. Т. Энгел, А. В. НазаренкоКлиника лучевой хирургии «Онкостоп»; Россия, 115478, Москва, Каширское шоссе, 23, стр. [2,3]. Достижения современной онкологии приводят к увеличению выживаемости больных раком, однако у выживших пациентов с течением времени увеличи-вается риск развития церебральных метастазов [4].Метастазы солидных опухолей составляют 90-95 % от общего количества метастазов в головной мозг, включая поражение мозговых оболочек [5].

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“…Numerous publication data suggests that some patients may benefit from surgical treatment or radio-surgery (with the application of stereotactic methods of radiotherapy -SBRT), where the survival period varies between a few months and more than one year (12 months). This, however, concerns mostly patients with isolated metastatic foci (1-3 metastases, with a diameter up to 3.5 cm) [17][18][19][20][21][22].…”

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The effectiveness of brain metastases radiotherapy in patients with melanoma

Szyszka-Charewicz

2017

Nowotwory. Journal of Oncology

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Introduction. Melanoma gives rise to 7-13% brain metastases (MBM -melanoma brain metastases) and is ranked third leading cause of brain metastases. The prognosis of patients with MBM is poor, with a median survival time of 3-6 months. Assessment of the value and limitations of three prognostic scores used in patients with melanoma brain metastases (MBM) was presented in this paper. Material and methods. In 110 patients with MBM, we executed an analysis of prognostic factors. All patients were treated with radiotherapy: whole brain radiotherapy performed as a treatment method in combination with chemotherapy (14 patients -12.7%), neurosurgery (12 patients -10.9% or stereotactic radiosurgery (8 patients -7.3%). Results. The median overall survival (OS) from diagnosis MBM was 4.8 months (95% CI 4.1-5.2 months). The analyses showed that the Karnofsky Performance Status and number of the MBM are independent significant prognostic factors. The analyses of OS, as a function of prognostic scores, showed that in the class with the best prognosis median OS was similar (7.2-10.7 months); and in the class with the worse prognosis median OS was also similar (range, 2.6-4.3 months). Conclusions. Our observations and data from literature showed that the presented scores can: distinguish classes of patients by prognosis before treatment, guide the choice of treatment methods and help design strategies for patient selection in clinical trials but they did not fully discriminate between unfavourable groups. NOWOTWORY J Oncol 2016; 66, 5: 367-374

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Phase II Trial of Radiosurgery for One to Three Newly Diagnosed Brain Metastases From Renal Cell Carcinoma, Melanoma, and Sarcoma: An Eastern Cooperative Oncology Group Study (E 6397)

Abstract: Intracranial failure rates without WBRT were 25.8% and 48.3% at 3 and 6 months, respectively. Delaying WBRT may be appropriate for some subgroups of patients with radioresistant tumors, but routine avoidance of WBRT should be approached judiciously.

Cited by 172 publications

References 27 publications

Temozolomide in advanced malignant melanoma with small brain metastases

Temozolomide in advanced malignant melanoma with small brain metastases

The History of Stereotactic Radiosurgery Development and Its Role in the Treatment of Brain Metastases

The effectiveness of brain metastases radiotherapy in patients with melanoma

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