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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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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

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  • corresponding author Alexander Muacevic - Neurochirurgische Klinik, Ludwig-Maximilians-Universität, Klinikum Großhadern, München
  • F. W. Kreth - Neurochirurgische Klinik, Ludwig-Maximilians-Universität, Klinikum Großhadern, München
  • J.-C. Tonn - Neurochirurgische Klinik, Ludwig-Maximilians-Universität, Klinikum Großhadern, München
  • B. Wowra - Deutsches Gamma Knife Zentrum, München

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMI.03.07

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0264.shtml

Published: April 23, 2004

© 2004 Muacevic et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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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.