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Stereotactic radiosurgery for multiple brain
metastases from breast carcinoma
Muacevic A, Kreth FW, Tonn JC, Wowra B
Department of Neurosurgery, Ludwig-Maximilians-University,
Klinikum Grosshadern, Munich, Germany. amuacevi@helios.med.uni-muenchen.de
Background.
The current
study analyzed the feasibility and outcome of stereotactic radiosurgery (SRS)
for treatment of brain metastases from breast carcinoma.
Methods.
During an
8-year period, 151 patients with a combined total of 620 brain metastases from
breast carcinoma underwent 197 outpatient SRS procedures.
Sixty-three percent of all patients had multiple brain metastases.
The median tumor volume was 2.2 cm(3) (range, 0.1-20.9 cm(3)).
The mean prescribed tumor dose was 19 +/- 4 grays.
Local/distant tumor recurrences were treated with additional radiosurgical
therapy for patients with stable systemic disease.
All patients were categorized according to the Radiation Therapy Oncology Group
classification.
Survival time and freedom from local tumor recurrence were analyzed using the
Kaplan-Meier method.
Prognostic factors were identified using the Cox proportional hazards
model.
Results.
The overall
median survival duration was 10 months after SRS.
Ninety-four percent of patients did not experience local brain tumor recurrence
after radiosurgery.
In addition, 70.2% of patients did not have disease recurrence in the
brain.
Most patients died of systemically progressing malignancy.
A Karnofsky performance score > 70 and recursive partitioning analysis Class
I were related to prolonged survival in the univariate and multivariate
analyses.
Age, whole-brain radiotherapy, surgery, number of metastases, chemotherapy, and
latency period from diagnosis of the primary tumor to the development of brain
metastases did not reach prognostic relevance in the multivariate model.
Patients with RPA I, II, and III survived 34.9, 9.1, and 7.9 months,
respectively.
There was no treatment related permanent morbidity and mortality.
The transient morbidity rate was 17%.
Sixteen patients exhibited symptomatic transient complications related to
treatment.
Conclusions.
The results
of the current study indicate that SRS is a feasible treatment concept for
selected patients with multiple brain metastases from breast carcinoma.
Copyright 2004 American Cancer Society.
PMID: 15073860 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15073860
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