title: Gamma knife radiosurgery for intracranial metastatic melanoma: a 6-year experience.
abstract: OBJECTIVE
  The purpose of this study was to evaluate retrospectively the effectiveness of stereotactic radiosurgery for intracranial metastatic melanoma and to identify prognostic factors related to tumor control and survival that might be helpful in determining appropriate therapy.
  
  
  METHODS
  Twenty-four patients with intracranial metastases (115 lesions) metastatic from melanoma underwent radiosurgery. In 14 patients (58.3%) whole-brain radiotherapy (WBRT) was performed, and in 12 (50%) chemotherapy was conducted before radiosurgery. The median tumor volume was 4 cm3 (range 1-15 cm3). The mean dose was 16.4 Gy (range 13-20 Gy) prescribed to the 50% isodose at the tumor margin. All cases were categorized according to the Recursive Partitioning Analysis classification for brain metastases. Univariate and multivariate analyses of survival were performed to determine significant prognostic factors affecting survival. The mean survival was 5.5 months after radiosurgery. The analyses revealed no difference in terms of survival between patients who underwent WBRT or chemotherapy and those who did not. A significant difference (p < 0.05) in mean survival was observed between patients receiving immunotherapy or those with a Karnofsky Performance Scale (KPS) score of greater than 90.
  
  
  CONCLUSIONS
  The treatment with systemic immunotherapy and a KPS score greater than 90 were factors associated with a better prognosis. Radiosurgery for melanoma-related brain metastases appears to be an effective treatment associated with few complications.
authors.affiliation: Department of Neurological Surgery, Wayne State University, Detroit, Michigan 48201, USA.
authors.forename: Jorge
authors.initials: J
authors.lastname: Gonzalez-Martinez
authors.forename: Laura
authors.initials: L
authors.lastname: Hernandez
authors.forename: Lucia
authors.initials: L
authors.lastname: Zamorano
authors.forename: Andrew
authors.initials: A
authors.lastname: Sloan
authors.forename: Kenneth
authors.initials: K
authors.lastname: Levin
authors.forename: Simon
authors.initials: S
authors.lastname: Lo
authors.forename: Qinghang
authors.initials: Q
authors.lastname: Li
authors.forename: Fernando
authors.initials: F
authors.lastname: Diaz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008875:Middle Aged; D011379:Prognosis; D016634:Radiosurgery; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology*; D016896:Treatment Outcome