gms | German Medical Science

59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

01. - 04.06.2008, Würzburg

Stereotactic interstitial radiosurgery for recurrent singular cerebral metastasis: Clinical outcome and local disease control of a salvage treatment regiment.

Stereotaktische interstitielle Radiochirurgie für rezidive singulärer zerebraler Metastasen: Klinische Ergebnisse und lokale Tumorkontrolle

Meeting Abstract

  • corresponding author M. Ruge - Clinic for Stereotactic and Functional Neurosurgery, University Cologne
  • V. Sturm - Clinic for Stereotactic and Functional Neurosurgery, University Cologne
  • J. Voges - Clinic for Stereotactic and Functional Neurosurgery, University Cologne
  • R. Lehrke - Clinic for Stereotactic and Functional Neurosurgery, University Cologne
  • M. Runge - Clinic for Stereotactic and Functional Neurosurgery, University Cologne
  • H. Treuer - Clinic for Stereotactic and Functional Neurosurgery, University Cologne
  • M. Maarouf - Clinic for Stereotactic and Functional Neurosurgery, University Cologne

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocMO.13.06

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2008/08dgnc129.shtml

Veröffentlicht: 30. Mai 2008

© 2008 Ruge et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Treatment options of patients with local recurrence of singular cerebral metastases after previous multimodal treatment are limited. Especially re-irradiation is often not an option due to the previous dose application to the surrounding tissue. Scares reports have demonstrated that stereotactic interstitial radiosurgery (IRS) is an effective and save treatment option to control cerebral metastases. In this study we applied this method to patients with local recurrence after previous treatment and evaluated the feasibility of the method, local disease control and clinical parameters.

Methods: For this retrospective study we selected all patients with local recurrence of a singular brain metastasis who received previous (multimodal) treatment (microsurgery, stereotactic radiosurgery, radiation therapy). Stereotactic interstitial radiosurgery (125iodine, 50 Gy surface dose, for 42 days) was applied to the recurrent metastasis in all cases. Neurological status, KPS, treatment related complications and local response of the metastasis (Macdonald criteria) were evaluated during follow-up.

Results: From 1999-2007 20 patients (13 famle/7male) with stable systemic disease were treated. Previous treatment included radiation therapy (17 patients), LINAC radiosurgery (6 patients) and/or microsurgical extirpation (10 patients). The mean and median follow-up period after IRS was 13.7 and 8.1 month, respectively. The target volume ranged from 2.3 to 22.5 ccm (mean 9.5). No treatment related permanent morbidity or mortality was observed. Neurological status improved in 25% or was unchanged. The KPS remained stable (≥70). Local tumor control was achieved in 90% (18/20 patients); two patients showed progressive local disease and received re-treatment with IRS.

Conclusions: These data demonstrate that stereotactic interstitial radiosurgery (IRS) using 125iodine seeds provides a minimal invasive, save, well tolerated and effective treatment option for patients with local recurrence of a singular brain metastasis when other treatment options are finally utilized.