Artikel
Outcome and local tumour control after stereotactic radiosurgery for multiple brain metastases of different tumour histologies
Ergebnisse und lokale Tumorkontrolle nach stereotaktischer Radiochirurgie für multiple Hirnmetastasen verschiedener Tumorentitäten
Suche in Medline nach
Autoren
Veröffentlicht: | 23. April 2004 |
---|
Gliederung
Text
Objective
To analyze the outcome and local tumour control after outpatient stereotactic radiosurgery (SRS) for patients harboring multiple brain metastases of different tumour histologies.
Methods
During a 8-years period, 563 patients with 2413 brain metastases of different tumour histologies (breast cancer 28%, malignant melanoma 20%, renal cell carcinoma 17%, NSC-lung cancer 35%) underwent 727 outpatient SRS procedures. 65% of all patients had multiple brain metastases. 79 patients received additional WBRT. The median tumour volume was 2.6 cm3 (range: 0.1 - 20.9 cm3). Mean prescribed tumour dose was 21.2 (+/-3.2) Gy. Local/distant tumour recurrences were treated by additional radiosurgical treatment for patients with stable systemic disease. All cases were categorized according to the RPA classification. Survival time and lack of local tumour recurrence was analysed with the Kaplan-Meier method. Prognostic factors were obtained from the Cox proportional hazard model.
Results
Overall median survival was 10 months after SRS. The local tumour control rate after radiosurgery was 95%. Most patients died because of systemically progressing cancer. RPA class I was related to prolonged survival in the univariate and multivariate analysis. Age, tumour histology, WBRT and the number of metastases did not reach prognostic relevance in the multivariate model. 14% of all patients showed symptomatic transient radiogenic complications. 2% died because of an intratumoural bleeding after SRS.
Conclusions
Outpatient stereotactic radiosurgery is a feasible and effective treatment method for patients with multiple brain metastases. Outcome is not depended on tumour histology.