Linac-Based Radiosurgery of Cerebral Melanoma Metastases
| Autor: | Jürgen Debus, Michael Wannenmacher, Klaus Herfarth, Andrea Pirzkall, Stefan Delorme, Udo Hofmann, Christoph Thilmann, Dietmar Zierhut, Dirk Schadendorf, Oxana Izwekowa |
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| Rok vydání: | 2003 |
| Předmět: |
Male
Oncology medicine.medical_specialty Time Factors medicine.medical_treatment Radiosurgery Metastasis Central nervous system disease Internal medicine medicine Humans Combined Modality Therapy Radiology Nuclear Medicine and imaging Neoplasm Metastasis Melanoma Survival rate Retrospective Studies Brain Neoplasms business.industry Retrospective cohort study Middle Aged medicine.disease humanities Survival Rate Radiation therapy Treatment Outcome Female Radiology Particle Accelerators business |
| Zdroj: | Strahlentherapie und Onkologie. 179:366-371 |
| ISSN: | 0179-7158 |
| DOI: | 10.1007/s00066-003-1050-z |
| Popis: | Stereotactic radiosurgery is an alternative option to neurosurgical excision in the management of patients with brain metastases. We retrospectively analyzed patients with brain metastases of malignant melanoma who were treated at our institution for outcome and prognostic factors.64 patients with 122 cerebral metastases were treated with stereotactic radiosurgery between 1986 and 2000. Twelve patients (19%) showed neurologic symptoms at the time of treatment, and 46 patients (72%) had extracerebral tumor manifestation at that time. The median dose to the 80% isodose line, prescribed to encompass the tumor margin, was 20 Gy (range, 15-22 Gy).Neurologic symptoms improved in five of twelve symptomatic patients. 41 patients remained asymptomatic or unchanged in their neurologic symptoms. Only five patients (8%) temporarily worsened neurologically after therapy despite no signs of tumor progression. With a mean follow-up time of 9.4 months, actuarial local control was 81% after 1 year. There was a statistically significant dose and size dependency of local tumor control. Median actuarial survival after treatment was 10.6 months. Patients without extracerebral tumor manifestation showed a superior survival (p = 0.04).Despite high local tumor control rates, the prognosis of patients with cerebral metastases of malignant melanoma remains poor. Stereotactic radiosurgery has the potential of stabilizing or improving neurologic symptoms in these patients in a palliative setting. |
| Databáze: | OpenAIRE |
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