Turkish Neurosurgery 2001 , Vol 11 , Num 1-2
GAMMA KNIFE RADIOSURGERY IN THE MANAGEMENT OF BRAIN METASTASES
Burak O BORAN, Türker KILIÇ, Selçuk PEKER, Meriç ŞENGÖZ, Başar ERDİVANLI, Necmettin PAMİR
Marmara University Faculty of Medicine , İstanbul, Turkey To report our experience with a series of consecutive patients with brain metastases, who underwent gamma knife radiosurgery during a 3 year period and to assess the prognostic significance of primary cancer type, number of intracranial lesions, and tumor locatian with regard to survival. We also examined the value of adjuvant whole brain irradiation for prolanging survival in this patient group. The records of 96 patients with 233 lesions were retrospectively reviewed. Primary cancer type, number of lesions per patient, and lesion volume, locatian and enhancement pattern were assessed in each case. The cases were divided into various subgroups, and rates of response to radiosurgery and survival times were compared using Kaplan-Meier analysis and the log rank test. The average follow-up period after radiosurgery was 36 weeks for all patients. Local tumor control was achieved in % 88 of the cases. When stratified to subgroups, patients with breast cancer demonstrated a longer survival compared to patients with renal cell cancer. Also patients with single metastases survived significantly longer than patients with 3 or more metastases. The patients who underwent adjuvant whole brain irradiation did not survived significantly longer than other patients. Gamma knife radiosurgery is an effective modality in the treatment of metastatic disease to the brain. Survival of the patients were effected by; primary cancer type, systemic disease status, and number of intracranial lesions. Adjuvant whole brain radiotherapy provides no significant survival benefit. Keywords : Gamma knife, Radiosurgery, Brain metastases
Corresponding author : Türker Kılıç, turkilic@turk.net