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56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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A randomized trial of surgery and radiotherapy versus radiosurgery alone in the treatment of single metastasis in the brain

Randomisierte Studie zum Vergleich von Chirurgie und Radiotherapie versus alleinige Radiochirurgie für die Behandlung von singulären Hirnmetastasen

Meeting Abstract

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  • corresponding author A. Muacevic - Department of Neurosurgery, Ludwig-Maximilians-University, Klinikum Großhadern, Munich
  • B. Wowra - Gamma Knife Center, Munich
  • J.-C. Tonn - Department of Neurosurgery, Ludwig-Maximilians-University, Klinikum Großhadern, Munich
  • H. J. Steiger - Department of Neurosurgery, Ludwig-Maximilians-University, Klinikum Großhadern, Munich
  • F. W. Kreth - Department of Neurosurgery, Ludwig-Maximilians-University, Klinikum Großhadern, Munich

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc11.05.-11.06

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0232.shtml

Published: May 4, 2005

© 2005 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 assess whether outpatient radiosurgery alone is as effective as surgery and whole brain irradiation (WBRT) for survival and neurological control of disease in patients with single brain metastasis.

Methods

64 patients with a single metastasis with a diameter up to 3 cm were randomly assigned to either microsurgery followed by whole brain radiotherapy (surgical group, 33 patients) or radiosurgery alone (radiosurgery group, 31 patients). All patients had tumours eligible for radiosurgical treatment. Primary end point was survival, secondary end points were tumour response and local control rates, overall intracranial recurrence rates, cause of death, and quality of life measurements. Survival time was analyzed with the Kaplan-Meier method. Prognostic factors were obtained from the Cox model.

Results

There was no significant difference between the 2 groups in overall length of survival (9.5 months surgery group, 10.3 months radiosurgery group; p=0.8) and local tumour control (82% surgery group, 97% radiosurgery group; p=0.06). Patients in the radiosurgery group experienced more distant recurrences (p=0.04) which could be effectively controlled with additional radiosurgical treatment. Survival improved in patients with an RPA class 1. Quality of life was favourable in the radiosurgery group.

Conclusions

In selected patients with cancer and single brain metastasis radiosurgery should be considered as primary treatment option because it is as effective as surgery and radiotherapy and offers a comparably good quality of life.