Liesa Dziggel1, Stefan Janssen2, Amira Bajrovic3, Theo Veninga4, Ngo Thuy Trang5, Mai Trong Khoa6, Steven E Schild7, Dirk Rades8. 1. Department of Radiation Oncology, University of Lübeck, Lübeck, Germany. 2. Department of Radiation Oncology, University of Lübeck, Lübeck, Germany Medical Practice for Radiotherapy and Radiation Oncology, Hannover, Germany. 3. Department of Radiotherapy, University Medical Center Eppendorf, Hamburg, Germany. 4. Department of Radiotherapy, Dr. Bernard Verbeeten Institute, Tilburg, the Netherlands. 5. Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam. 6. Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam Department of Nuclear Mediciume, Hanoi Medical University, Hanoi, Vietnam. 7. Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A. 8. Department of Radiation Oncology, University of Lübeck, Lübeck, Germany rades.dirk@gmx.net.
Abstract
BACKGROUND/AIM: Patients with gynecological malignancies account for 2% of patients with cerebral metastases. Many patients receive whole-brain irradiation (WBI) alone. Local therapies (resection, stereotactic radiosurgery (SRS)) are becoming more popular. This study compared intracerebral control after local therapy to WBI alone in patients with gynecological malignancies. PATIENTS AND METHODS: Of 56 patients, 45 received WBI alone, 6 SRS alone and 5 resection plus WBI. Treatment type, age, performance score, cancer site, number of cerebral lesions, metastases outside the brain, recursive partitioning analysis (RPA) class and period from gynecological cancer diagnosis to brain metastasis treatment were evaluated. RESULTS: On univariate analyses, local therapy (p=0.003), single cerebral lesion (p<0.001) and RPA class 1/2 (p=0.027) were positively related to intracerebral control. On Cox regression analysis, local therapy (p=0.013) and RPA class 1/2 (p=0.014) were significant. CONCLUSION: Local therapies led to better intracerebral control than WBI alone and should be considered for brain metastasis from gynecological malignancies whenever reasonable. Copyright
BACKGROUND/AIM: Patients with gynecological malignancies account for 2% of patients with cerebral metastases. Many patients receive whole-brain irradiation (WBI) alone. Local therapies (resection, stereotactic radiosurgery (SRS)) are becoming more popular. This study compared intracerebral control after local therapy to WBI alone in patients with gynecological malignancies. PATIENTS AND METHODS: Of 56 patients, 45 received WBI alone, 6 SRS alone and 5 resection plus WBI. Treatment type, age, performance score, cancer site, number of cerebral lesions, metastases outside the brain, recursive partitioning analysis (RPA) class and period from gynecological cancer diagnosis to brain metastasis treatment were evaluated. RESULTS: On univariate analyses, local therapy (p=0.003), single cerebral lesion (p<0.001) and RPA class 1/2 (p=0.027) were positively related to intracerebral control. On Cox regression analysis, local therapy (p=0.013) and RPA class 1/2 (p=0.014) were significant. CONCLUSION: Local therapies led to better intracerebral control than WBI alone and should be considered for brain metastasis from gynecological malignancies whenever reasonable. Copyright