BACKGROUND: Treatment of tumors metastatic to the brainstem with stereotactic radiosurgery (SRS) has not been widely studied. OBJECTIVE: To identify the effects of SRS on patients with brainstem metastases by assessing duration of local progression-free survival (LPFS) and overall survival. METHODS: We retrospectively reviewed clinical data collected from 60 patients undergoing linear accelerator-based SRS for tumors metastatic to the brainstem between August 1994 and December 2007. The LPFS and overall survival were calculated with the Kaplan-Meier method. Prognostic factors were evaluated with the log-rank test and Cox proportional hazards model. RESULTS: The median age of patients was 61 years (range, 39-85 years); the median treated lesion volume was 1.0 mL (range, 0.1-8.7 mL); and the median SRS dose was 15 Gy (range, 8-18 Gy). The median overall survival interval after SRS was 4 months (95% confidence interval, 3.4-4.9 months); crude local tumor control was 76%; and median LPFS was 5.7 months (95% confidence interval, 3.0-8.4 months). Shorter overall survival was associated with a pretreatment tumor volume ≥4 mL (P < .001) and male sex (P = .03). Shorter LPFS was associated with a pretreatment tumor volume ≥4 mL (P = .008), a melanoma primary tumor (P = .002), and the presence of necrosis in pre-SRS magnetic resonance imaging (P = .04). A Basic Score for Brain Metastases of 2 to 3 vs 1 (P = .007) and a Score Index for Radiosurgery >5 (P = .003) were significantly associated with longer survival. Twelve patients (20%) developed SRS-related complications. CONCLUSION: Stereotactic radiosurgery provides noninvasive treatment and favorable local tumor control for patients with brainstem metastases.
BACKGROUND: Treatment of tumors metastatic to the brainstem with stereotactic radiosurgery (SRS) has not been widely studied. OBJECTIVE: To identify the effects of SRS on patients with brainstem metastases by assessing duration of local progression-free survival (LPFS) and overall survival. METHODS: We retrospectively reviewed clinical data collected from 60 patients undergoing linear accelerator-based SRS for tumors metastatic to the brainstem between August 1994 and December 2007. The LPFS and overall survival were calculated with the Kaplan-Meier method. Prognostic factors were evaluated with the log-rank test and Cox proportional hazards model. RESULTS: The median age of patients was 61 years (range, 39-85 years); the median treated lesion volume was 1.0 mL (range, 0.1-8.7 mL); and the median SRS dose was 15 Gy (range, 8-18 Gy). The median overall survival interval after SRS was 4 months (95% confidence interval, 3.4-4.9 months); crude local tumor control was 76%; and median LPFS was 5.7 months (95% confidence interval, 3.0-8.4 months). Shorter overall survival was associated with a pretreatment tumor volume ≥4 mL (P < .001) and male sex (P = .03). Shorter LPFS was associated with a pretreatment tumor volume ≥4 mL (P = .008), a melanoma primary tumor (P = .002), and the presence of necrosis in pre-SRS magnetic resonance imaging (P = .04). A Basic Score for Brain Metastases of 2 to 3 vs 1 (P = .007) and a Score Index for Radiosurgery >5 (P = .003) were significantly associated with longer survival. Twelve patients (20%) developed SRS-related complications. CONCLUSION: Stereotactic radiosurgery provides noninvasive treatment and favorable local tumor control for patients with brainstem 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: 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
Authors: Andrew F Lamm; Ameer L Elaimy; Alexander R Mackay; Robert K Fairbanks; John J Demakas; Barton S Cooke; Christopher M Lee; Blake S Taylor; Wayne T Lamoreaux Journal: Case Rep Oncol Med Date: 2012-09-29
Authors: Jonathan E Leeman; David A Clump; Rodney E Wegner; Dwight E Heron; Steven A Burton; Arlan H Mintz Journal: Radiat Oncol Date: 2012-07-11 Impact factor: 3.481
Authors: Andrew F Lamm; Ameer L Elaimy; Wayne T Lamoreaux; Alexander R Mackay; Robert K Fairbanks; John J Demakas; Barton S Cooke; Christopher M Lee Journal: ISRN Surg Date: 2013-04-11