scholarly journals Low-Dose Gamma Knife Radiosurgery Plus Whole-Brain Radiation Therapy for Advanced Stage Brain Metastasis

2017 ◽  
Vol 99 (2) ◽  
pp. E94
Author(s):  
A. Miyakawa ◽  
S. Takemoto ◽  
T. Hirai ◽  
T. Serizawa ◽  
Y. Shibamoto
Keyword(s):  
Radiation Therapy ◽  
Brain Metastasis ◽  
Gamma Knife ◽  
Low Dose ◽  
Gamma Knife Radiosurgery ◽  
Whole Brain Radiation Therapy ◽  
Advanced Stage ◽  
Whole Brain ◽  
Whole Brain Radiation ◽  
Brain Radiation

Gamma knife treatment for multiple metastatic brain tumors compared with whole-brain radiation therapy

2000 ◽  
Vol 93 (supplement_3) ◽  
pp. 32-36 ◽  
Author(s):  
Toru Serizawa ◽  
Toshihiko Iuchi ◽  
Junichi Ono ◽  
Naokatsu Saeki ◽  
Katsunobu Osato ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Cerebral Metastases ◽  
Whole Brain Radiation Therapy ◽  
Whole Brain ◽  
Content Type ◽  
Whole Brain Radiation ◽  
Brain Radiation ◽  
Fine Print

Object. The purpose of this retrospective study was to compare the effectiveness of gamma knife radiosurgery (GKS) for multiple cerebral metastases with that of whole-brain radiation therapy (WBRT). Methods. Ninety-six consecutive patients with cerebral metastases from nonsmall cell lung cancer were treated between 1990 and 1999. The entry criteria were the presence of between one and 10 multiple brain lesions at initial diagnosis, no surgically inaccessible tumors with more than a 30-mm diameter, no carcinomatous meningitis, and more than 2 months of life expectancy. The patients were divided into two groups: the GKS group (62 patients) and the WBRT group (34 patients). In the GKS group, large lesions (> 30 mm) were removed surgically and all other small lesions (≤ 30 mm) were treated by GKS. New distant lesions were treated by repeated GKS without prophylactic WBRT. In the WBRT group, the patients were treated by the traditional combined therapy of WBRT and surgery. In both groups, chemotherapy was administered according to the primary physician's protocol. The two groups did not differ in terms of age, sex, initial Karnofsky Performance Scale (KPS) score, type, lesion number, and size of lesion, systemic control, and chemotherapy. Neurological survival and qualitative survival of the GKS group were longer than those of the WBRT group. In multivariate analysis, significant poor prognostic factors were systemically uncontrolled patients, WBRT group, and poor initial KPS score. Conclusions. Gamma knife radiosurgery without prophylactic WBRT could be a primary choice of treatment for patients with as many as 10 cerebral metastases from nonsmall cell cancer.

The Louisiana State University Experience in the Management of Single Small Cerebellar Metastasis

Neurosurgery ◽  
2010 ◽  
Vol 67 (6) ◽  
pp. 1515-1522 ◽  
Author(s):  
Vijayakumar Javalkar ◽  
Raul Cardenas ◽  
Federico Ampil ◽  
Osama Ahmed ◽  
Runhua Shi ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Gamma Knife ◽  
Median Survival ◽  
Gamma Knife Radiosurgery ◽  
Whole Brain Radiation Therapy ◽  
Treatment Modalities ◽  
Whole Brain ◽  
Whole Brain Radiation ◽  
Brain Radiation ◽  
Cerebellar Metastasis

Abstract BACKGROUND: Cerebellar metastasis is often believed to be a more immediately life-threatening complication than brain metastasis in other locations. It is considered a negative prognostic factor in patients with systemic cancers. Despite its clinical importance and technological advances, the survival outcomes of patients with single small cerebellar metastases are rarely studied. OBJECTIVE: To retrospectively evaluate our experience in the management of patients with single small cerebellar metastasis and compare the treatment modalities. MATERIAL AND METHODS: A total of 35 patients with single small cerebellar metastasis were included in this retrospective analysis. Of the 35 patients, 24 had surgery followed by whole-brain radiation therapy and 11 had Gamma Knife radiosurgery alone. RESULTS: The median survival for the whole cohort was 5.6 months after the intervention. No significant differences were noted in median survival between the surgery plus whole-brain radiation therapy and the Gamma Knife radiosurgery alone groups (6.3 months: 95% confidence interval [CI], 4.0-8.6; vs 5.0 months: 95% CI, 1.9-8.1; P = .9). There was no difference in the median time to local progression, distance progression, and overall progression between the 2 groups. Patients with hydrocephalus had a significantly lower survival rate (median, 3.3 months; 95% CI, 0.0-6.6) compared with those without hydrocephalus (median, 6.9 months; 95% CI, 4.4-9.8; P = .02). In the Cox regression model, the significant predictor of survival was hydrocephalus (P = .01; hazard ratio, 3.5; 95% CI, 1.3-9.1) after propensity score adjustment. CONCLUSION: Treatment with Gamma Knife radiosurgery alone and surgery plus whole-brain radiation therapy were both efficacious in patients with single small cerebellar metastasis. Overall survival was nearly identical in both treatment groups.

Stereotactic drainage and Gamma Knife radiosurgery of cystic brain metastasis

2008 ◽  
Vol 109 (2) ◽  
pp. 259-267 ◽  
Author(s):  
Alberto Franzin ◽  
Alberto Vimercati ◽  
Piero Picozzi ◽  
Carlo Serra ◽  
Silvia Snider ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Brain Metastasis ◽  
Confidence Interval ◽  
Gamma Knife ◽  
Tumor Volume ◽  
Whole Brain Radiation Therapy ◽  
Whole Brain ◽  
Whole Brain Radiation ◽  
The Mean ◽  
Brain Radiation

Object Treatment options for patients with brain metastasis include tumor resection, whole-brain radiation therapy, and radiosurgery. A single treatment is not useful in cases of multiple tumors, of which at least 1 is a cystic tumor. The purpose of this study was to assess the role of stereotactic drainage and Gamma Knife surgery (GKS) in the treatment of cystic brain metastasis. Methods Between January 2001 and November 2005, 680 consecutive patients with brain metastases underwent GKS at our hospital, 30 of whom were included in this study (18 males and 12 females, mean age 60.6 ± 11 years, range 38–75 years). Inclusion criteria were: 1) no prior whole-brain radiation therapy or resection procedure; 2) a maximum of 4 lesions on preoperative MR imaging; 3) at least 1 cystic lesion; 4) a Karnofsky Performance Scale score ≥ 70; and 5) histological diagnosis of a malignant tumor. Results Non–small cell lung carcinoma was the primary cancer in most patients (19 patients [63.3%]). A single metastasis was present in 13 patients (43.3%). There was a total of 81 tumors, 33 of which were cystic. Ten patients (33.3%) were in recursive partitioning analysis Class I, and 20 (66.6%) were in Class II. Before drainage the mean tumor volume was 21.8 ml (range 3.8–68 ml); before GKS the mean tumor volume was 10.1 ml (range 1.2–32 ml). The mean prescription dose to the tumor margin was 19.5 Gy (range 12–25 Gy). Overall median patient survival was 15 months. The 1- and 2-year survival rates were 54.7% (95% confidence interval 45.3–64.1%) and 34.2% (95% confidence interval 23.1–45.3%). Local tumor control was achieved in 91.3% of the patients. Conclusions The results of this study support the use of a multiple stereotactic approach in cases of multiple and cystic brain metastasis.

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