Gamma knife radiosurgery for ten or more brain metastases

• Published in: Journal of Korean Neurosurgical Society 2008, 44(6), , pp.358-363
• Main Authors: Kim, Chang-Hyun, Im, Yong-Seok, Nam, Do-Hyun, Park, Kwan, Kim, Jong-Hyun, Lee, Jung-Il
• Format: Article
• Language: English
• Subjects: Clinical; 신경외과학
• ISSN: 2005-3711; 2005-2711; 1598-7876
• DOI: 10.3340/jkns.2008.44.6.358

This study was performed to assess the efficacy of GKS in patients with ten or more brain metastases. From Aug 2002 to Dec 2007, twenty-six patients (13 men and 13 women) with ten or more cerebral metastatic lesions underwent GKS. The mean age was 55 years (32-80). All patients had Karnofsky performance status (KPS) score of 70 or better. According to recursive partitioning analysis (RPA) classification, 3 patients belonged to class I and 23 to class II. The location of primary tumor was lung (21), breast (3) and unknown (2). The mean number of the lesions per patient was 16.6 (10-37). The mean cumulated volume was 10.9 cc (1.0-42.2). The median marginal dose was 15 Gy (9-23). Overall survival and the prognostic factors for the survival were retrospectively analyzed by using Kaplan Meier method and univariate analysis. Overall median survival from GKS was 34 weeks (8-199). Local control was possible for 79.5% of the lesions and control of all the lesions was possible in at least 14 patients (53.8%) until 6 months after GKS. New lesions appeared in 7 (26.9%) patients during the same period. At the last follow-up, 18 patients died; 6 (33.3%) from systemic causes, 10 (55.6%) from neurological causes, and 2 (11.1%) from unknown causes. Synchronous onset in non-small cell lung cancer (p=0.007), high KPS score (>/=80, p=0.029), and controlled primary disease (p=0.020) were favorable prognostic factors in univariate analysis. In carefully selected patients, GKS may be a treatment option for ten or more brain metastases.