Linear accelerator-based stereotactic radiosurgery in 140 brain metastases from malignant melanoma

BMC Cancer

Research Article

Alina Stenke¹  Stephanie E. Combs¹  Jürgen Debus¹  Henrik Hauswald¹ 

[1] Department of Radiation Oncology, Heidelberg University Hospital, INF 400, 69120, Heidelberg, Germany;

关键词: Malignant melanoma;    Brain metastases;    SRS;    Stereotactic radiosurgery;    Radiotherapy;   

DOI  :  10.1186/s12885-015-1517-1

 received in 2014-10-01, accepted in 2015-06-26,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundTo retrospectively access outcome and prognostic parameters of linear accelerator-based stereotactic radiosurgery in brain metastases from malignant melanoma.MethodsBetween 1990 and 2011 140 brain metastases in 84 patients with malignant melanoma (median age 56 years) were treated with stereotactic radiosurgery. At initial stereotactic radiosurgery 48 % of patients showed extracerebral control. The median count of brain metastases in a single patient was 1, the median diameter was 12 mm. The median dose applied was 20 Gy/80 % isodose enclosing.ResultsThe median follow-up was 7 months and the median overall survival 9 months. The 6-, 12- and 24 month overall survival rates were 71 %, 39 % and 25 % respectively. Cerebral follow-up imaging showed complete remission in 20 brain metastases, partial remission in 39 brain metastases, stable disease in 54 brain metastases, progressive disease in 24 brain metastases and pseudo-progression in 3 brain metastases. Median intracerebral control was 5.3 months and the 6- and 12-month intracerebral progression-free survival rates 48 % and 38 %, respectively. Upon univariate analysis, extracerebral control (log-rank, p < 0.001), the response to stereotactic radiosurgery (log-rank, p < 0.001), the number of brain metastases (log-rank, p = 0.007), the recursive partitioning analysis class (log-rank, p = 0.027) and the diagnosis-specific graded prognostic assessment score (log-rank, p = 0.011) were prognostic for overall survival. The most common clinical side effect was headache common toxicity criteria grade I. The most common radiological finding during follow-up was localized edema within the stereotactic radiosurgery high dose region.ConclusionStereotactic radiosurgery is a well-tolerated and effective treatment option for brain metastases in malignant melanoma and was able to achieve local remissions in several cases. Furthermore, especially patients with controlled extracerebral disease and a low count of brain metastases seem to benefit from this treatment modality. Prospective trials analysing the effects of combined stereotactic radiosurgery and new systemic agents are warranted.

【 授权许可】

CC BY   
© Hauswald et al. 2015