PURPOSE: To evaluate the efficacy and @entity137 of gamma knife radiosurgery in the treatment of @entity320 @entity3 to the brain. @entity1 AND METHODS: We retrospectively reviewed 55 @entity1 with single or multiple intracranial @entity320 @entity3 treated at the University of California, San Francisco, with gamma knife radiosurgery from 1991 through 1995. Sixteen @entity1 were treated with gamma knife radiosurgery for recurrence following previous radiation therapy, 11 received radiosurgery as a boost to whole-brain radiation therapy, and 28 had radiosurgery alone for initial management of brain @entity3 . The median minimum radiosurgery tumor dose for 140 treated lesions was 19 Gy (range, 10-22 Gy) prescribed at the 35% to 90% isodose contour (median, 50%). The median total target volume per @entity1 was 6.1 cc (range, 0.25-28.3 cc). RESULTS: With a median follow-up of 75 weeks in living @entity1 , the median survival times were 35 weeks overall: 35 weeks for @entity1 with solitary @entity3 versus 33 weeks for those with multiple @entity3 . A factor that was significant in univariate analysis of survival was total target volume treated. This parameter remained significant on multivariate analysis. The actuarial median freedom from progression analyzed by lesion for 113 lesions in 46 @entity1 with imaging follow-up was 89 weeks with 6-month and 1-year actuarial freedom from progression rates of 89% (95% confidence interval, 80%-95%) and 77% (95% confidence interval, 62%-87%). In univariate analysis, improved freedom from progression was associated with smaller target volume treated, smaller maximum diameter, or higher prescribed dose. Four @entity1 (7%) developed acute Radiation Therapy Oncology Group grade > or = 2 morbidity, and five @entity1 (9%) developed late grade > or = 2 morbidity. DISCUSSION: Median survival and freedom from progression in @entity1 treated with radiosurgery for @entity320 metastatic to the brain are comparable to results in published radiosurgery series of grouped histologies. For @entity320 @entity1 , total @entity5 volume appears to be of greater prognostic significance than the absolute number of @entity3 treated. We conclude that gamma knife radiosurgery is effective and should be considered among various management strategies.

Gamma knife radiosurgery for XXXX @entity3 .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'PATIENTS'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity5 :: ('MESH:D009369', 'Disease') :: ['intracranial tumor'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases'] @entity320 :: ('MESH:D008545', 'Disease') :: ['melanoma']
@entity320 :: (MESH:D008545,Disease) :: ['malignant melanoma brain']
