Neurosurgery - Abstract: Volume 62(5) May 2008 p = 1018-1032 LINEAR ACCELERATOR STEREOTACTIC RADIOSURGERY FOR METASTATIC = BRAIN TUMORS: 17 YEARS OF EXPERIENCE AT THE UNIVERSITY OF = FLORIDA.

From: Subject: Neurosurgery - Abstract: Volume 62(5) May 2008 p 1018-1032 LINEAR ACCELERATOR STEREOTACTIC RADIOSURGERY FOR METASTATIC BRAIN TUMORS: 17 YEARS OF EXPERIENCE AT THE UNIVERSITY OF FLORIDA. Date: Sat, 12 Jul 2008 23:25:45 +0200 MIME-Version: 1.0 Content-Type: multipart/related; type="text/html"; boundary="----=_NextPart_000_0006_01C8E476.9C3FA630" X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2900.5512 This is a multi-part message in MIME format. ------=_NextPart_000_0006_01C8E476.9C3FA630 Content-Type: text/html; charset="utf-8" Content-Transfer-Encoding: quoted-printable Content-Location: http://www.neurosurgery-online.com/pt/re/neurosurg/abstract.00006123-200805000-00003.htm;jsessionid=L5gbjXFG1MQDhd5M0vWPjbNccCz4kZ1Q7hgNLnRCnZNrFYGpLylQ!-574814035!181195629!8091!-1 =EF=BB=BF Neurosurgery - Abstract: Volume 62(5) May 2008 p = 1018-1032 LINEAR ACCELERATOR STEREOTACTIC RADIOSURGERY FOR METASTATIC = BRAIN TUMORS: 17 YEARS OF EXPERIENCE AT THE UNIVERSITY OF = FLORIDA.

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LINEAR ACCELERATOR STEREOTACTIC RADIOSURGERY FOR = METASTATIC=20 BRAIN TUMORS: 17 YEARS OF EXPERIENCE AT THE UNIVERSITY OF=20 FLORIDA.

CLINICAL STUDIES =
Neurosurgery. 62(5):1018-1032, May 2008.
Swinson, = Bradley M.=20 B.S.; Friedman, William A. M.D.

Abstract:
OBJECTIVE: To review one of = the=20 largest single-institution experiences treating metastatic brain = disease=20 with stereotactic radiosurgery.
METHODS: We performed a retrospective analysis of 619 = patients who=20 underwent linear accelerator-based stereotactic radiosurgery for = 1569=20 brain metastases between May 1989 and February 2006. Patient=20 characteristics and treatment parameters were obtained = prospectively.=20 Patients were followed up at regular intervals clinically and = with=20 imaging studies to document local control, regional control, and = survival. Cox proportional hazards analysis was performed using = SAS=20 version 9.1 software (SAS Institute, Cary, NC).
RESULTS: Median actuarial survival was 7.9 months. 1- and = 2-year=20 actuarial survival probabilities were 0.36 and 0.14, = respectively.=20 Radiation Therapy Oncology Group Recursive Partitioning Analysis = Class I=20 or II was associated with improved survival, but the difference = between=20 the two was insignificant. Female sex, younger age, higher = Karnofsky=20 performance status, controlled primary tumor, absence of = systemic=20 metastases, asynchronous presentation of brain metastasis, fewer = brain=20 metastases, smaller total volume of brain metastases, surgery = prior to=20 radiosurgery, and multiple radiosurgical treatments were also = associated=20 with improved survival. Melanoma metastasis was associated with = impaired=20 survival. Local control was achieved in 84.3% of all lesions = treated. 1-=20 and 2-year actuarial local control probabilities were 0.82 and = 0.72,=20 respectively. Whole brain radiation therapy prior to = radiosurgery was=20 associated with improved regional control.
CONCLUSIONS: Linear accelerator-based stereotactic = radiosurgery is a=20 safe and effective treatment for patients with metastatic brain = tumors.=20 Selection of patients who are likely to benefit most from = radiosurgery=20 is complex and treatment decisions should be based on the entire = clinical picture.
Copyright (C) by the Congress of Neurological Surgeons=20

Copyright =C2=A9 2008, Congress of Neurological Surgeons. All = rights=20 reserved.
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