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논문 기본 정보

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학술저널
저자정보
Lee, Chul-Kyu (Department of Neurosurgery, Gamma Knife Center, Ajou University School of Medicine) Lee, Sang-Ryul (Department of Neurosurgery, Gamma Knife Center, Ajou University School of Medicine) Cho, Jin-Mo (Department of Neurosurgery, Gamma Knife Center, Ajou University School of Medicine) Yang, Kyung-Ah (Department of Neurosurgery, Gamma Knife Center, Ajou University School of Medicine) Kim, Se-Hyuk (Department of Neurosurgery, Gamma Knife Center, Ajou University School of Medicine)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제50권 제3호
발행연도
2011.1
수록면
179 - 184 (6page)

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Objective : The aim of this study is to evaluate the therapeutic effects of gamma knife radiosurgery (GKRS) in patients with multiple brain metastases and to investigate prognostic factors related to treatment outcome. Methods : We retrospectively reviewed clinico-radiological and dosimetric data of 36 patients with 4-14 brain metastases who underwent GKRS for 264 lesions between August 2008 and April 2011. The most common primary tumor site was the lung (n=22), followed by breast (n=7). At GKRS, the median Karnofsky performance scale score was 90 and the mean tumor volume was 1.2 cc (0.002-12.6). The mean prescription dose of 17.8 Gy was delivered to the mean 61.1% isodose line. Among 264 metastases, 175 lesions were assessed for treatment response by at least one imaging follow-up. Results : The overall median survival after GKRS was $9.1{\pm}1.7$ months. Among various factors, primary tumor control was a significant prognostic factor ($11.1{\pm}$1.3 months vs. $3.3{\pm}2.4$ months, p=0.031). The calculated local tumor control rate at 6 and 9 months after GKRS were 87.9% and 84.2%, respectively. Paddick's conformity index (>0.75) was significantly related to local tumor control. The actuarial peritumoral edema reduction rate was 22.4% at 6 months. Conclusion : According to our results, GKRS can provide beneficial effect for the patients with multiple (4 or more) brain metastases, when systemic cancer is controlled. And, careful dosimetry is essential for local tumor control. Therefore, GKRS can be considered as one of the treatment modalities for multiple brain metastase.
#Gamma knife radiosurgery #Metastases #Cerebral edema

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참고문헌 (19)

참고문헌 신청
Andrews DW / 2004 / Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases : phase III results of the RTOG 9508 randomised trial / Lancet 363:1665~1672 google schola Aoyama H / 2006 / Stereotactic radiosurgery plus whole-brain radiation therapy vs. stereotactic radiosurgery alone for treatment of brain metastases : a randomized controlled trial / JAMA 295:2483~2491 google schola Chiou SM / 2010 / Validity of the graded prognostic assessment-derived index to predict brain-metastatic patients’ survival after Gamma Knife radiosurgery / Int J Radiat Oncol Biol Phys 78:1156~1162 google schola DiStefano A / 1979 / The natural history of breast cancer patients with brain metastases / Cancer 44:1913~1918 google schola Gaspar LE / 2000 / Validation of the RTOG recursive partitioning analysis (RPA) classification for brain metastases / Int J Radiat Oncol Biol Phys 47:1001~1006 google schola

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