OBJECTIVE: To analyze 18 months of results of gamma knife stereotactic radiosurgery in the treatment of brain metastases and determine factors affecting outcome by examining the effectiveness of additional external-beam radiotherapy (XRT). MATERIALS AND METHODS: Between January 2000 and September 2001, 61 @entity1 with 103 @entity5 diagnosed as cerebral metastases were treated with gamma knife. Mean @entity1 age was 57 years (range = 36-81). @entity2 (55.7%) was the most common primary @entity5 , followed by @entity320 (14.8%) and @entity0 (11.5%). Mean KPS of the @entity1 was 70 (range = 50-90). Twenty-seven @entity1 had solitary metastases while 34 had @entity5 . Forty-three @entity1 (59 @entity5 in total) received only radiosurgery, while 18 @entity1 (44 @entity5 in total) had prior XRT. @entity5 volume ranged from 0.5 to 33 cm(3) (mean = 9.74 cm(3)). Mean marginal dose prescription to the @entity5 was 15 Gy (range = 11-21 Gy). RESULTS: Median follow-up was 11 months. Twenty-one @entity1 (34.4%) were alive at last follow-up and 40 (65.6%) had died. Seventeen @entity204 (42.5%) were reported to be due to progressive @entity75 , while 23 @entity204 (57.5%) were due to uncontrolled primary. Control of the treated lesions was achieved in 45 @entity1 (73.8%) and 84 @entity5 (81.6%). Mean overall survival of the @entity1 is 8 months (range = 1-19 months). The actuarial 12-month @entity5 control rate using the Kaplan-Meier method for this series is 68.2 +/- 0.06%. Results of the log-rank test revealed that younger age (<55 years), small @entity5 volume (<10 cm(3)), and increasing @entity5 dose (>15 Gy) correlated with improved @entity75 -free survival (p < 0.05). Overall survival, local @entity5 control rate and the freedom from @entity75 period (based on the appearance of new @entity1313 after radiosurgery) were analyzed separately for the groups receiving radiosurgery alone and those with prior XRT to detect any additional benefit of XRT. No statistically significant difference was found between the two groups for any of the considered outcomes. CONCLUSION: Gamma knife stereotactic radiosurgery is a safe and effective treatment option for @entity1 with cerebral metastases. It provides survival benefits and improves quality of life by achieving excellent control of the @entity75 , irrespective of @entity1 ' age or number of @entity1313 . The addition of XRT in younger @entity1 with small brain metastases does not improve survival and/or control of the @entity75 .

Gamma knife radiosurgery for brain metastases: do XXXX benefit from adjuvant external-beam radiotherapy? An 18-month comparative analysis.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast carcinoma'] @entity1313 :: ('MESH:D001932', 'Disease') :: ['brain tumors'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'multiple tumors', 'cancer', 'Tumor', 'tumors'] @entity75 :: ('MESH:D001927', 'Disease') :: ['brain disease'] @entity2 :: ('MESH:D008175', 'Disease') :: ['Lung carcinoma'] @entity204 :: ('MESH:D003643', 'Disease') :: ['deaths'] @entity320 :: ('MESH:D008545', 'Disease') :: ['melanoma']
@entity1 :: (9606,Species) :: ['patients']
