BACKGROUND: Stereotactic radiosurgery has become important in the treatment of metastatic brain tumours and is often the first choice modality for eloquent or deep locations such as the brain stem. This study evaluated the efficacy of gamma knife radiosurgery (GKS) for the treatment of brain stem metastases. METHODS: The medical records of 25 patients with 31 tumours, 11 men and 14 women aged 42 to 78 years (mean 57.1 years), who underwent GKS for metastatic tumours in the brain stem were retrospectively reviewed. The results of GKS were evaluated according to the change in tumour size on neuro-imaging. FINDINGS: The most common location of the primary malignancy was the lung followed by the breast. Adenocarcinoma was found in 19 patients (24 lesions). No case of squamous cell carcinoma was found. The mean calculated tumour volume was 2.1 cm(3) and the mean prescription dose to the tumour margin was 13.0 Gy. Mean duration of neuro-imaging follow up was 5.2 months and the overall tumour control rate was 77.4%. There was a significant correlation between the marginal dose delivered and the effect on neuro-imaging. New radiation-induced injury in the surrounding brain occurred in only 2 patients. INTERPRETATION: GKS for brain stem metastases using a marginal dose of 15 Gy or less is effective and relatively safe. Accurate targeting of the tumour and safe dose planning are essential to obtain satisfactory results with GKS for brain stem metastases.
BACKGROUND: Stereotactic radiosurgery has become important in the treatment of metastatic brain tumours and is often the first choice modality for eloquent or deep locations such as the brain stem. This study evaluated the efficacy of gamma knife radiosurgery (GKS) for the treatment of brain stem metastases. METHODS: The medical records of 25 patients with 31 tumours, 11 men and 14 women aged 42 to 78 years (mean 57.1 years), who underwent GKS for metastatic tumours in the brain stem were retrospectively reviewed. The results of GKS were evaluated according to the change in tumour size on neuro-imaging. FINDINGS: The most common location of the primary malignancy was the lung followed by the breast. Adenocarcinoma was found in 19 patients (24 lesions). No case of squamous cell carcinoma was found. The mean calculated tumour volume was 2.1 cm(3) and the mean prescription dose to the tumour margin was 13.0 Gy. Mean duration of neuro-imaging follow up was 5.2 months and the overall tumour control rate was 77.4%. There was a significant correlation between the marginal dose delivered and the effect on neuro-imaging. New radiation-induced injury in the surrounding brain occurred in only 2 patients. INTERPRETATION: GKS for brain stem metastases using a marginal dose of 15 Gy or less is effective and relatively safe. Accurate targeting of the tumour and safe dose planning are essential to obtain satisfactory results with GKS for brain stem metastases.
Authors: Khinh Ranh Voong; Benjamin Farnia; Qianghu Wang; Dershan Luo; Mary F McAleer; Ganesh Rao; Nandita Guha-Thakurta; Anna Likhacheva; Amol J Ghia; Paul D Brown; Jing Li Journal: Neurooncol Pract Date: 2015-03-03
Authors: Jeremy M Kilburn; Thomas L Ellis; James F Lovato; James J Urbanic; J Daniel Bourland; J Daniel Bourland; Michael T Munley; Allan F Deguzman; Kevin P McMullen; Edward G Shaw; Stephen B Tatter; Michael D Chan Journal: J Neurooncol Date: 2014-02-07 Impact factor: 4.130
Authors: Daniel M Trifiletti; Cheng-Chia Lee; Hideyuki Kano; Jonathan Cohen; James Janopaul-Naylor; Michelle Alonso-Basanta; John Y K Lee; Gabriela Simonova; Roman Liscak; Amparo Wolf; Svetlana Kvint; Inga S Grills; Matthew Johnson; Kang-Du Liu; Chung-Jung Lin; David Mathieu; France Héroux; Danilo Silva; Mayur Sharma; Christopher P Cifarelli; Christopher N Watson; Joshua D Hack; John G Golfinos; Douglas Kondziolka; Gene Barnett; L Dade Lunsford; Jason P Sheehan Journal: Int J Radiat Oncol Biol Phys Date: 2016-06-15 Impact factor: 7.038
Authors: Paul J Kelly; Yijie Brittany Lin; Alvin Y C Yu; Alexander E Ropper; Paul L Nguyen; Karen J Marcus; Fred L Hacker; Stephanie E Weiss Journal: J Neurooncol Date: 2011-01-07 Impact factor: 4.130
Authors: Daniel M Trifiletti; Cheng-Chia Lee; William Winardi; Nirav V Patel; Chun-Po Yen; James M Larner; Jason P Sheehan Journal: J Neurooncol Date: 2015-09-04 Impact factor: 4.130