title: Radiosurgery without whole brain radiotherapy in melanoma brain metastases. Club de Cancérologie Cutanée.
abstract: To evaluate the effectiveness of radiosurgery without whole brain radiotherapy in the palliative treatment of melanoma brain metastases, we retrospectively assessed the results in 35 patients: 4 with a solitary brain metastasis, 13 with a single brain metastasis and metastases elsewhere and 18 with multiple brain metastases. The local control rate was 98.2% (55/56 metastases) at 3 months. Median survival was 22 months in patients with a solitary brain metastasis, 7.5 months in patients with a single brain metastasis and metastases elsewhere, and 4 months in patients with multiple brain metastases. Complications were unusual and surgery was required in 2 of 35 patients. These results show for the first time that melanoma patients with a unique brain metastasis with or without metastases elsewhere clearly benefit from tumour control easily obtained by radiosurgery. Although the comparison of radiosurgery with surgery and/or whole brain radiotherapy cannot be adequately addressed, radiosurgery alone seems to provide similar results with lower morbidity and impact on quality of life.
authors.affiliation: Dermatology Department, Hôpital Sainte-Marguerite, Marseille, France.
authors.forename: J J
authors.initials: JJ
authors.lastname: Grob
authors.forename: J
authors.initials: J
authors.lastname: Regis
authors.forename: R
authors.initials: R
authors.lastname: Laurans
authors.forename: M
authors.initials: M
authors.lastname: Delaunay
authors.forename: P
authors.initials: P
authors.lastname: Wolkenstein
authors.forename: K
authors.initials: K
authors.lastname: Paul
authors.forename: P
authors.initials: P
authors.lastname: Souteyrand
authors.forename: M C
authors.initials: MC
authors.lastname: Koeppel
authors.forename: X
authors.initials: X
authors.lastname: Murraciole
authors.forename: J C
authors.initials: JC
authors.lastname: Perragut
authors.forename: J J
authors.initials: JJ
authors.lastname: Bonerandi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D006801:Humans; D008545:Melanoma / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D008875:Middle Aged; D009607:Nitrosourea Compounds / Q000627:therapeutic use; D009943:Organophosphorus Compounds / Q000627:therapeutic use; D010166:Palliative Care / Q000379:methods*; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D009607:Nitrosourea Compounds; D009943:Organophosphorus Compounds; C054368:fotemustine