Stereotactic radiosurgery as therapy for melanoma, renal carcinoma, and sarcoma brain metastases

Impact of added surgical resection and whole-brain radiotherapy

Ganesh Rao, Paul Klimo, Clinton J. Thompson, Wolfram Samlowski, Michael Wang, Gordon Watson, Dennis Shrieve, Randy L. Jensen

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose: Brain metastases of melanoma, renal carcinoma, and sarcoma have traditionally responded poorly to conventional treatments, including surgery and whole-brain radiotherapy (WBRT). Several studies have suggested a beneficial effect of stereotactic radiosurgery (SRS). We evaluated our institutional experience with systematic SRS in patients harboring these "radioresistant" metastases. Methods and Materials: A total of 68 patients with brain metastases from melanoma, renal carcinoma, and sarcoma underwent SRS with or without WBRT or surgical resection. All patients had Karnofsky performance scores >70, and SRS was performed before the initiation of systemic therapy. The survival time was calculated from the diagnosis of brain metastases using the Kaplan-Meier product-limit method. Statistical significance was calculated using the log-rank test. Factors influencing survival, including surgical resection, WBRT, gender, number of SRS sessions, and histologic type, were evaluated retrospectively using Cox univariate models. Results: The overall median survival was 427 days (14.2 months), which appears superior to the results obtained with conventional WBRT. The addition of neither surgery nor WBRT to SRS provided a statistically significant increase in survival. Conclusion: Our results suggest that patients undergoing SRS for up to five cerebral metastases from "radioresistant" tumors (melanoma, renal cell carcinoma, and sarcoma) have survival rates comparable to those in other series of more selected patients. The addition of surgical resection or WBRT did not result in improved survival in our series.

Original languageEnglish (US)
JournalInternational Journal of Radiation Oncology Biology Physics
Volume66
Issue number4 SUPPL.
DOIs
StatePublished - Nov 15 2006
Externally publishedYes

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Radiosurgery
metastasis
Sarcoma
brain
radiation therapy
Melanoma
therapy
Radiotherapy
cancer
Neoplasm Metastasis
Carcinoma
Kidney
Brain
Survival
Therapeutics
surgery
rank tests
Kaplan-Meier Estimate
Renal Cell Carcinoma
Proportional Hazards Models

All Science Journal Classification (ASJC) codes

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Stereotactic radiosurgery as therapy for melanoma, renal carcinoma, and sarcoma brain metastases : Impact of added surgical resection and whole-brain radiotherapy. / Rao, Ganesh; Klimo, Paul; Thompson, Clinton J.; Samlowski, Wolfram; Wang, Michael; Watson, Gordon; Shrieve, Dennis; Jensen, Randy L.

In: International Journal of Radiation Oncology Biology Physics, Vol. 66, No. 4 SUPPL., 15.11.2006.

Research output: Contribution to journalArticle

Rao, Ganesh ; Klimo, Paul ; Thompson, Clinton J. ; Samlowski, Wolfram ; Wang, Michael ; Watson, Gordon ; Shrieve, Dennis ; Jensen, Randy L. / Stereotactic radiosurgery as therapy for melanoma, renal carcinoma, and sarcoma brain metastases : Impact of added surgical resection and whole-brain radiotherapy. In: International Journal of Radiation Oncology Biology Physics. 2006 ; Vol. 66, No. 4 SUPPL.
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