BACKGROUND: Prostate cancer metastatic to the brain is uncommon and has been associated historically with a poor prognosis. It has been suggested that SRS may be an effective treatment. METHODS: We analyzed a prospective, institutional review board-approved database of patients treated with SRS and identified 5 patients with prostate cancer metastasis. Clinical, pathologic, radiographic, treatment, and outcome information regarding the primary/systemic disease status, and brain metastases were collected. RESULTS: Mean age at the time of treatment for CNS parenchymal metastasis was 72.0 +/- 8.3 years and lesions developed 82.0 +/- 65.1 months after the initial tumor was identified. Four patients had a single lesion and 1 had 4; 3 patients were treated with SRS alone, 1 with WBRT and SRS, and 1 with surgery, then WBRT and SRS. All were symptomatic. Stereotactic radiosurgery controlled the brain metastases in all 5 patients, with functional improvement and with a typical increase of 1 grade in the Karnofsky performance score. Mean survival was at least 10.0 +/- 6.7 months (range, 6-22+ months). Two patients died of conditions unrelated to prostate cancer and 2 of systemic disease progression; 1is alive and asymptomatic. There were no local SRS failures and no new CNS lesions. CONCLUSIONS: Stereotactic radiosurgery for prostate cancer metastatic to the brain, alone or in combination with brain radiation therapy and surgery, is a safe, effective treatment that improves neurologic symptoms and function and may prolong survival.
BACKGROUND:Prostate cancer metastatic to the brain is uncommon and has been associated historically with a poor prognosis. It has been suggested that SRS may be an effective treatment. METHODS: We analyzed a prospective, institutional review board-approved database of patients treated with SRS and identified 5 patients with prostate cancer metastasis. Clinical, pathologic, radiographic, treatment, and outcome information regarding the primary/systemic disease status, and brain metastases were collected. RESULTS: Mean age at the time of treatment for CNS parenchymal metastasis was 72.0 +/- 8.3 years and lesions developed 82.0 +/- 65.1 months after the initial tumor was identified. Four patients had a single lesion and 1 had 4; 3 patients were treated with SRS alone, 1 with WBRT and SRS, and 1 with surgery, then WBRT and SRS. All were symptomatic. Stereotactic radiosurgery controlled the brain metastases in all 5 patients, with functional improvement and with a typical increase of 1 grade in the Karnofsky performance score. Mean survival was at least 10.0 +/- 6.7 months (range, 6-22+ months). Two patients died of conditions unrelated to prostate cancer and 2 of systemic disease progression; 1is alive and asymptomatic. There were no local SRS failures and no new CNS lesions. CONCLUSIONS: Stereotactic radiosurgery for prostate cancer metastatic to the brain, alone or in combination with brain radiation therapy and surgery, is a safe, effective treatment that improves neurologic symptoms and function and may prolong survival.
Authors: Timothy L Sita; Katarina G Petras; Q Eileen Wafford; Mark A Berendsen; Tim J Kruser Journal: J Neurooncol Date: 2017-05-25 Impact factor: 4.130
Authors: Thomas Flannery; Hideyuki Kano; Ajay Niranjan; Edward A Monaco; John C Flickinger; L Dade Lunsford; Douglas Kondziolka Journal: J Neurooncol Date: 2009-07-17 Impact factor: 4.130
Authors: Kobisha Rajeswaran; Kaitlin Muzio; Juan Briones; Mary Jane Lim-Fat; Chia-Lin Tseng; Martin Smoragiewicz; Jay Detsky; Urban Emmenegger Journal: J Clin Med Date: 2022-07-18 Impact factor: 4.964