Volume not number of metastases: Gamma Knife radiosurgery management of intracranial lesions from an Australian perspective. (April 2019)

• Record Type: Journal Article
• Authors: Izard, Michael A.; Moutrie, Vaughan; Rogers, Jeffrey M.; Beath, Ken; Grace, Michael; Karle, Bianca; Ho, Annie; Fuller, John W.
• Is Part Of: Radiotherapy and oncology. Volume 133(2019)
• Page Start: 43
• Page End: 49
• Publication Date: 2019-04
• Subjects: EORTC European Organization for Research and Treatment of Cancer -- GK Gamma Knife -- ICTV intracranial tumor volume -- SRS stereotactic radiosurgery -- QoL quality of life -- WBRT whole-brain radiotherapy; Brain metastases -- Gamma knife surgery -- Stereotactic radiotherapy -- Stereotactic radiosurgery -- Neurosurgery; Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2018.12.018
• Languages: English
• ISSNs: 0167-8140

Abstract

Highlights: Gamma Knife efficacy for treating greater numbers of brain metastases is unclear. Survival outcomes in 180 cases with a median 5.5 (range 1–47) lesions were examined. Total tumor volume was more effective in predicting outcome than tumor number. Cases with volumes >9.1 cm 3 had the poorest median survival time of 5.2 months. A tumor volume index is encouraged for predicting stereotactic treatment outcomes. Abstract: Background and purpose: To assess the response of the first cohort of patients treated with Gamma Knife radiosurgery in Australia. Materials and methods: A prospectively collected cohort of 180 patients with intracranial metastases from different primaries was treated between August 2010 and July 2017. Survival was calculated using the Kaplan–Meier's method. Cox regression was used for multivariate analysis. Results: Currently 141 patients (78.3%) have died of their disease. The median survival for the group as a whole was 9.2 months, with observed differences resulting from the volume of tumor burden (11.4 months for volumes <3.2 cm 3 to 5.16 months for volume >9.1 cm 3 ). Overall 2-year survival was 20.7%. Conclusion: Results from the first Gamma Knife radiosurgery center in Australia showed that the treatment is feasible and effective, consistent with the international experience. For patients with larger numbers of intracranial metastases, the total volume of the intracranial burden may be of more significance in predicting outcomes. While there appeared to be a difference in survival by histologic origin, this could be related to concurrent systemic immunotherapy available for certain tumors.