Gammaknife radiosurgery in patients with melanoma brain metastasis
Abstract
Melanoma refers to malignant tumors with a primary metastasis to the brain. Complications associated with brain damage are the leading cause of death in patients with this pathology. The study analyzed the results of treatment of 57 patients with metastatic brain lesions. Treatment was conducted on Leksell Gamma Knife 4C (Elekta, Sweden) in the period from 2009 to 2012. The average lifespan of the treated patients was 7,2 months from the first radiosurgical operation, local control was achieved in 92% metastatic brain lesions, disease-free three-month survival rate was 73%, six-month 24% and twelve-month 7%. Our data confirm that radiosurgery is an effective method for the treatment of patients with metastasis of radioresistant tumors, including melanoma, to the brain. The treatment increases survival rate and allows to achieve high local control with minimal mortality.
About the Authors
A. V. Kuzmin
Radiosurgery center MIBS
Russian Federation
Russian Federation
I. S. Zubatkina
Radiosurgery center MIBS
Russian Federation
Russian Federation
P. I. Ivanov
Radiosurgery center MIBS
Russian Federation
Russian Federation
A. V. Vorobiev
Radiosurgery center MIBS
Russian Federation
Russian Federation
A. I. Lubinsky
Radiosurgery center MIBS
Russian Federation
Russian Federation
References
1. Bafaloukos D., Gogas H. The treatment of brain metastases in melanoma patients. Cancer Treat. Rev. 2004, v. 30, p. 515-520.
2. Barth A., Wanek L.A., Morton D.L. Prognostic factors in 1,521 melanoma patients with distant metastases. J. Am. Coll Surg. 1995, v. 181, p. 193-201.
3. Brand C.U., Ellwanger U., Stroebel W. et al. Prolonged survival of 2 years or longer for patients with disseminated melanoma. An analysis of related prognostic factors. Cancer. 1997, v. 79, p. 2345-2353.
4. Brown P.D., Brown C.A., Pollock B.E., Gorman D.A., Foote R.L. Stereotactic radiosurgery for patients with «radioresistant» brain metastases. Neurosurgery. 2002, v. 51, p. 656-665.
5. Chang E.L., Selek U., Hassenbusch S.J., 3rd, Maor M.H., Allen P.K., Mahajan A., Sawaya R., Woo S.Y. Outcome variation among «radioresistant» brain metastases treated with stereotactic radiosurgery. Neurosurgery. 2005, v. 56, p. 936-945.
6. Chason J.L., Walker F.B., Landers J.W Metastatic carcinoma in the central nervous system and dorsal root ganglia. A prospective autopsy study. Cancer. 1963, v. 16, p. 781-787.
7. Coffey R.J., Flickinger J.C., Lunsford L.D., Bissonette D.J. Solitary brain metastasis: radiosurgery in lieu of microsurgery in 32 patients. Acta Neurochir Suppl (Wien.). 1991, v. 52, p. 90-92.
8. Fell D.A., Leavens M.E., McBride C.M. Surgical versus non-surgical management of metastatic melanoma of the brain. Neurosurgery. 1980, v. 7, p. 238-242.
9. Gieger M., Wu J.K., Ling M.N., Wazer D., Tsai J.S., Engler M.J. Response of intracranial melanoma metastases to stereotactic radiosurgery. Radiat. Oncol. Invest. 1997, v. 5, p. 72-80.
10. Gonzalez-Martinez J., Hernandez L., Zamorano L. et al. Gamma knife radiosurgery for intracranial metastatic melanoma: a 6-year experience. J. Neurosurg. 2002, v. 97 (5 Suppl), p. 494-498.
11. Grob J.J., Regis J., Laurans R. et al. Radiosurgery without whole brain radiotherapy in melanoma brain metastases. Eur. J. Cancer. 1998, v. 34, p. 1187-1192.
12. Hall H.I., Miller D.R., Rogers J.D., Bewerse B. Update on the incidence and mortality from melanoma in the United States. J. Am. Acad. Dermatol. 1999, v. 40, p. 35-42.
13. Jemal A., Devesa S.S., Hartge P., Tucker M.A. Recent trends in cutaneous melanoma incidence among whites in the United States. J. Natl. Cancer Inst. 2001, v. 93, p. 678-683.
14. Kihlstrom L., Karlsson B., Lindquist C., Noren G., Rahn T Gamma knife surgery for cerebral metastasis. Acta Neurochir. Suppl (Wien.). 1991, v. 52, p. 87-89.
15. McWilliams R.R., Brown P.D., Buckner J.C., Link M.J., Markovic S.N: Treatment ofbrain metastases from melanoma. Mayo Clin. Proc. 2003, v. 78, p. 1529-1536.
16. Mingione V., Oliveira M., Prasad D., Steiner M., Steiner L. Gamma surgery for melanoma metastases in the brain. J. Neurosurg. 2002, v. 96, p. 544-551.
17. Mori Y., Kondziolka D., Flickinger J.C., Kirkwood J.M., Agarwala S., Lunsford L.D. Stereotactic radiosurgery for cerebral metastatic melanoma: factors affecting local disease control and survival. Int. J. Radiat. Oncol. Biol. Phys. 1998, v. 42, p. 581-589.
18. Seung S.K., Sneed P.K., McDermott M.W. et al. Gamma knife radiosurgery for malignant melanoma brain metastases. Cancer J. Sci. Am. 1998, v. 4, p. 103-109.
19. Tarhini A.A., Agarwala S.S. Management of brain metastases in patients with melanoma. Curr. Opin. Oncol. 2004, v. 16, p. 161-166.
20. Tsao H., Atkins M.B., Sober A.J: Management of cutaneous melanoma. N. Engl. J. Med. 2004, v. 351, p. 998-1012.
21. Yu C., Chen J.C., Apuzzo M.L. et al. Metastatic melanoma to the brain: prognostic factors after gamma knife radiosurgery. Int. J. Radiat. Oncol. Biol. Phys. 2002, v. 52, p. 1277-1287.
Review
For citations:
Kuzmin A.V., Zubatkina I.S., Ivanov P.I., Vorobiev A.V., Lubinsky A.I. Gammaknife radiosurgery in patients with melanoma brain metastasis. Bone and soft tissue sarcomas, tumors of the skin. 2012;(2):37-41. (In Russ.)
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