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KMID : 0942820120110010016
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Journal of Korean Brain Tumor Society
2012 Volume.11 No. 1 p.16 ~ p.22
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Stereotactic Radiosurgery for Five or More Brain Metastases
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Lee Won-Seok
Kim Young-Hoon
Han Jung-Ho
Kim Chae-Yong
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Abstract
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Objectives: This study aimed to evaluate the therapeutic efficacy of stereotactic radiosurgery (SRS) for 5 or more brain metastases and find associated prognostic factors.
Patients and Methods:Thirty-nine patients with 5 or more brain metastases were treated with SRS. The mean patient age was 57.1±13.8 years (range, 22-84), and 12 (30.8%) patients were male. The primary cancers were non-small cell lung cancer (NSCLC)(n=27), small cell lung cancer (n=2), breast cancer (n=3), gastrointestinal cancer (n=2), genitourinary cancer (n=3), and sarcoma (n=2). The mean number of metastases was 11.0±6.5 (range, 5-33). The mean tumor volume was 0.76±2.09 cm3 (range, 0.002-15.40), and the mean marginal radiation dose was 19.20 Gy±2.83 Gy (range, 10-24) at a 54.26±9.12 % isodose line.
Results: The median overall survival (OS) and progression-free survival (PFS) after SRS were 14.6 months (95% CI, 7.3-21.9) and 9.1 months (95% CI, 5.9-12.3), respectively. Local control failure occurred in 12 patients (30.8%), and distant disease progression developed in 8 patients (20.5%). In the multivariate analysis, primary NSCLC and Karnofsky’s Performance Score (KPS) were significantly associated with OS (p=0.023 and 0.040, respectively). The early tumor response was the only independent prognostic factor (p=0.008) for PFS.
Conclusion: SRS was an effective treatment option for patients with 5 or more brain metastases, improving both OS and PFS in patients with multiple brain metastases.
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KEYWORD
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Brain metastases, Multiple, Overall survival, Progression-free survival, Stereotactic radiosurgery.
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