Dirk Rades1, Lena Sehmisch2, Stefan Huttenlocher2, Oliver Blank3, Dagmar Hornung4, Patrick Terheyden5, Jan Gliemroth6, Steven E Schild7. 1. Department of Radiation Oncology, University of Lübeck, Lübeck, Germany Rades.Dirk@gmx.net. 2. Department of Radiation Oncology, University of Lübeck, Lübeck, Germany. 3. Department of Radiation Oncology, University of Lübeck, Lübeck, Germany CyberKnife Center Northern Germany, Güstrow, Germany. 4. Department of Radiation Oncology, University Medical Center Eppendorf, Hamburg, Germany. 5. Department of Dermatology, University of Lübeck, Lübeck, Germany. 6. Department of Neurosurgery, University of Lübeck, Lübeck, Germany. 7. Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A.
Abstract
BACKGROUND/AIM: To compare different doses of stereotactic radiosurgery (SRS) for 1-3 newly-diagnosed cerebral metastases from melanoma. PATIENTS AND METHODS: Fifty-four patients were assigned to dose groups of 20 Gy (N=36) and 21-22.5 Gy (N=18). Variables additionally analyzed were age, gender, Karnofsky Performance Score (KPS), lactate dehydrogenase (LDH) before SRS, number of cerebral lesions, extracranial lesions, time from melanoma diagnosis to SRS. RESULTS: The 12-month local control was 72% after 20 Gy and 100% after 21-22.5 Gy (p=0.020). Freedom from new cerebral metastases (p=0.13) and survival (p=0.13) showed no association with SRS dose. On multivariate analyses, improved local control showed significant associations with SRS doses of 21-22.5 Gy (p=0.007) and normal lactate dehydrogenase levels (p=0.018). Improved survival was associated with normal LDH levels (p=0.006) and KPS 90-100 (p=0.046). CONCLUSION: SRS doses of 21-22.5 Gy resulted in better local control than 20 Gy. Freedom from new brain metastases and survival were not significantly different. Copyright
BACKGROUND/AIM: To compare different doses of stereotactic radiosurgery (SRS) for 1-3 newly-diagnosed cerebral metastases from melanoma. PATIENTS AND METHODS: Fifty-four patients were assigned to dose groups of 20 Gy (N=36) and 21-22.5 Gy (N=18). Variables additionally analyzed were age, gender, Karnofsky Performance Score (KPS), lactate dehydrogenase (LDH) before SRS, number of cerebral lesions, extracranial lesions, time from melanoma diagnosis to SRS. RESULTS: The 12-month local control was 72% after 20 Gy and 100% after 21-22.5 Gy (p=0.020). Freedom from new cerebral metastases (p=0.13) and survival (p=0.13) showed no association with SRS dose. On multivariate analyses, improved local control showed significant associations with SRS doses of 21-22.5 Gy (p=0.007) and normal lactate dehydrogenase levels (p=0.018). Improved survival was associated with normal LDH levels (p=0.006) and KPS 90-100 (p=0.046). CONCLUSION:SRS doses of 21-22.5 Gy resulted in better local control than 20 Gy. Freedom from new brain metastases and survival were not significantly different. Copyright
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