Therapeutic effect of combined hyperbaric oxygen and radiation therapy for single brain metastasis and its influence on osteopontin and MMP‑9

✓ From July, 1977, through December, 1978, a series of 33 patients with solitary brain metastases underwent surgical resection and postoperative radiation therapy at Memorial Sloan-Kettering Cancer Center. Sequential computerized tomography (CT) scanning was performed to determine the incidence of local recurrence and new brain metastases. The cause of death was identified by clinical follow-up study. The median survival for the entire group was 8 months, with a 1-year survival of 44%. Of the patients with no evidence of systemic cancer at the time of craniotomy, 81% lived 1 year. Local recurrence was noted in one patient known to have subtotal removal of tumor, and three patients developed carcinomatous meningitis. Of the 20 patients who died, four died within 30 days following surgery; three died of causes related to the central nervous system (CNS); and 13 (65%) succumbed to systemic cancer. These data show that recurrence in the CNS following surgery and radiation therapy for single brain metastasis is low, and that serial CT scanning provides a much better measure of the effectiveness of treatment of this complication of cancer than survival times. It is suggested that results of CT and neurological examination be used as indices when comparing different modes of therapy for brain metastases. Significant further improvement in survival of these patients is dependent on control of systemic cancer.

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The role of radiation therapy following resection of single brain metastasis from melanoma

Neurology ◽

10.1212/wnl.40.1.158 ◽

1990 ◽

Vol 40 (1) ◽

pp. 158-158 ◽

Cited By ~ 124

Author(s):

N. A. Hagen ◽

C. Cirrincione ◽

H. T. Thaler ◽

L. M. DeAngelis

Keyword(s):

Radiation Therapy ◽

Brain Metastasis ◽

Single Brain Metastasis

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Results of a phase II trial of the GliaSite Radiation Therapy System for the treatment of newly diagnosed, resected single brain metastases

Journal of Neurosurgery ◽

10.3171/jns.2006.105.3.375 ◽

2006 ◽

Vol 105 (3) ◽

pp. 375-384 ◽

Cited By ~ 72

Author(s):

Lisa R. Rogers ◽

Jack P. Rock ◽

Allen K. Sills ◽

Michael A. Vogelbaum ◽

John H. Suh ◽

...

Keyword(s):

Radiation Therapy ◽

Brain Metastasis ◽

Patient Survival ◽

Radiation Necrosis ◽

Functional Independence ◽

Local Control Rate ◽

Whole Brain Radiation ◽

Single Brain Metastasis ◽

Brain Radiation ◽

Patient Survival Time

Object The aim of this study was to evaluate the effectiveness of brachytherapy using the GliaSite Radiation Therapy System in patients with a newly diagnosed resected single brain metastasis. The primary end point of the study was local tumor control. The secondary end points included patient survival, distant brain recurrence, quality of life, and treatment toxicity. Methods The authors conducted a prospective multiinstitutional phase II study of GliaSite brachytherapy prescribed at a 60-Gy dose administered to a 1-cm depth after resection of a single brain metastasis. No whole-brain radiation therapy was given. Patients were assessed at 1 and 3 months after brachytherapy and every 3 months thereafter for up to 2 years. Seventy-one patients were enrolled at 13 centers. A GliaSite balloon catheter was implanted in 62 patients. Fifty-four patients received brachytherapy. The median patient age was 60 years. The most common tumor (54%) was non–small cell lung cancer. Fifty-seven percent of patients had brain metastasis only, whereas 43% had extracranial metastasis. The median final administered dose was 60 Gy. The magnetic resonance imaging–determined local control rate, based on several different methods, was 82 to 87%. Both the median patient survival time and the median duration of functional independence were 40 weeks. Among the 35 patients who died, the cause of death was neurological in 11%. Thirteen patients underwent reoperation for suspected tumor recurrence or radiation necrosis, and histological diagnoses included radiation necrosis without tumor (nine patients), radiation necrosis mixed with tumor (two patients), and tumor only (two patients). Extracranial metastasis, tumor size, and radiation necrosis were significant factors affecting patient survival. Conclusions In patients with a resected single brain metastasis, GliaSite brachytherapy leads to a local control rate, median patient survival time, and duration of functional independence similar to those achieved with resection plus whole-brain radiation therapy.

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