Long‐term survivors after gamma knife radiosurgery for brain metastases

摘要: BACKGROUND Stereotactic radiosurgery, with or without whole-brain radiation therapy, has become a valued management choice for patients brain metastases, although their median survival remains limited. In who receive successful extracranial cancer care, have controlled intracranial disease are living longer. The authors evaluated all metastasis in lived ≥ 4 years after radiosurgery to determine clinical and treatment patterns potentially responsible outcome. METHODS Six hundred seventy-seven metastases underwent 781 procedures between 1988 2000. Data from the entire series were reviewed; and, if had of survival, then they information on treatment, symptoms, imaging responses, need further morbidity. These long-term survivors compared cohort < 3 months (n = 100 patients). RESULTS Forty-four (6.5%) survived > (mean, 69 mos 16 still alive). mean age at was 53 (maximum age, 72 yrs), Karnofsky performance score (KPS) 90. lung 15 patients), breast 9 kidney 7 skin (melanoma; n 6 patients) most frequent primary sites. Two more organ sites outside involved 18 (41%), tumor plus lymph nodes 10 (23%), only (20%), (16%), indicating that extended possible even multiorgan disease. Serial 133 tumors showed 99 smaller (74%), 22 unchanged (17%), 12 larger (9%). Four permanent neurologic deficit management, six resection radiosurgery. Compared limited (< mos), higher initial KPS (P 0.01), fewer 0.04), less 0.00005). CONCLUSIONS Although expected may be limited, selected effective care malignant can prolonged, good-quality survival. extent time predictive outcome, but this does not necessarily cannot live is effective. Cancer 2005. © 2005 American Society.