PURPOSE: Approximately 10% of patients with metastatic renal cell carcinoma are diagnosed with brain metastases. Most of these patients receive palliative radiotherapy and die of progressive brain metastatic disease. This retrospective study examines the M. D. Anderson Cancer Center experience with such patients who received only whole brain radiation therapy (WBRT). METHODS AND MATERIALS: Records of 200 patients with brain metastases from renal carcinoma who were treated at M. D. Anderson Cancer Center between 1976 and 1993 were reviewed. Of these patients, 119 received WBRT only and constitute the basis of this study. Different prognostic factors were analyzed. RESULTS: Overall median survival time from diagnosis of the brain metastases was 4.4 months. Multiple brain tumors were treated in 70 patients (58.8%) who had a survival of 3.0 months compared with 4.4 months for patients having a single brain metastasis (p = 0.043). Among 117 patients the causes of death were neurologic in 90 (76%), systemic cancer in 19 (16%), and unknown in 9 (8%). Survival rates at 6 months, 1 year, and 2 years, were 33.6, 16.8, and 5.9%, respectively. Patients in whom brain metastases were diagnosed synchronously with a renal primary (n = 24) had a median survival time of 3.4 months compared with 3.2 months for those 95 who were diagnosed metachronously (p < 0.79, NS). In the Cox multivariate analysis of 13 possible prognostic factors, only a single brain metastasis (p = 0.0329), lack of distant metastases at the time of diagnosis (p = 0.0056), and tumor diameter < or = 2 cm (p < 0.0016) were statistically significant. CONCLUSION: These unsatisfactory results with WBRT suggest that more aggressive approaches, such as surgery or radiosurgery should be applied whenever possible.
PURPOSE: Approximately 10% of patients with metastatic renal cell carcinoma are diagnosed with brain metastases. Most of these patients receive palliative radiotherapy and die of progressive brain metastatic disease. This retrospective study examines the M. D. Anderson Cancer Center experience with such patients who received only whole brain radiation therapy (WBRT). METHODS AND MATERIALS: Records of 200 patients with brain metastases from renal carcinoma who were treated at M. D. Anderson Cancer Center between 1976 and 1993 were reviewed. Of these patients, 119 received WBRT only and constitute the basis of this study. Different prognostic factors were analyzed. RESULTS: Overall median survival time from diagnosis of the brain metastases was 4.4 months. Multiple brain tumors were treated in 70 patients (58.8%) who had a survival of 3.0 months compared with 4.4 months for patients having a single brain metastasis (p = 0.043). Among 117 patients the causes of death were neurologic in 90 (76%), systemic cancer in 19 (16%), and unknown in 9 (8%). Survival rates at 6 months, 1 year, and 2 years, were 33.6, 16.8, and 5.9%, respectively. Patients in whom brain metastases were diagnosed synchronously with a renal primary (n = 24) had a median survival time of 3.4 months compared with 3.2 months for those 95 who were diagnosed metachronously (p < 0.79, NS). In the Cox multivariate analysis of 13 possible prognostic factors, only a single brain metastasis (p = 0.0329), lack of distant metastases at the time of diagnosis (p = 0.0056), and tumor diameter < or = 2 cm (p < 0.0016) were statistically significant. CONCLUSION: These unsatisfactory results with WBRT suggest that more aggressive approaches, such as surgery or radiosurgery should be applied whenever possible.
Authors: Ammoren E Dohm; Ryan Hughes; William Wheless; Michael Lecompte; Claire Lanier; Jimmy Ruiz; Kounosuke Watabe; Fei Xing; Jing Su; Christina Cramer; Adrian Laxton; Stephen Tatter; Michael D Chan Journal: J Neurooncol Date: 2018-10-26 Impact factor: 4.130
Authors: D Clay Cochran; Michael D Chan; Mebea Aklilu; James F Lovato; Natalie K Alphonse; J Daniel Bourland; James J Urbanic; Kevin P McMullen; Edward G Shaw; Stephen B Tatter; Thomas L Ellis Journal: J Neurosurg Date: 2012-03-02 Impact factor: 5.115
Authors: Paul J Black; Brandi R Page; John T Lucas; Ryan T Hughes; Adrian W Laxton; Stephen B Tatter; Michael T Munley; Michael D Chan Journal: J Radiosurg SBRT Date: 2015
Authors: Emory R McTyre; Adam G Johnson; Jimmy Ruiz; Scott Isom; John T Lucas; William H Hinson; Kounosuke Watabe; Adrian W Laxton; Stephen B Tatter; Michael D Chan Journal: Neuro Oncol Date: 2017-04-01 Impact factor: 12.300