title: Gamma Knife stereotactic radiosurgery for intracranial metastases from conventionally radioresistant primary cancers: outcome analysis of survival and control of brain disease.
abstract: OBJECTIVE
  The aim of this study was to analyze our experience with stereotactic radiosurgery in the management of patients with brain metastases from radioresistant primary cancers.
  
  
  METHODS
  We retrospectively reviewed the clinical record of those patients for the outcome measures. All data were coded and entered into multivariate regression analysis for studying the relationship between survival and other variables.
  
  
  RESULTS
  Over a 48-month period, 31 patients received radiosurgery for brain metastases from renal cell carcinoma (n = 7), malignant melanoma (n = 14), or colon carcinoma (n = 10) at our institution. The followup ranged from 1-48 months (mean = 17 months). At the time of last followup, 11 patients (35.5%) were alive and 20 had died. Six deaths (30%) resulted from progressive brain disease while 14 patients died from progressive primary and/or extracranial metastatic disease. Mean survival from radiosurgery was 12 months (95% CI, 7-17) and the median survival was 7 months. The 1 and 2 year actuarial survival rates were 32.5 +/- 1% and 12.2 +/- 1% respectively. The overall survival was directly related to tumor control time (P <0.001) and inversely to the number of metastases (P = 0.031).
  
  
  CONCLUSIONS
  Gamma Knife stereotactic radiosurgery for intracranial metastases from conventionally radioresistant primary cancers is a safe and effective method to provide better local control of the brain disease and improve survival time.
authors.affiliation: Department of Neurosurgery, Louisiana State University Health Science Center, Shreveport, LA 71130-3932, USA.
authors.forename: Anthony H
authors.initials: AH
authors.lastname: Sin
authors.forename: Raul J
authors.initials: RJ
authors.lastname: Cardenas
authors.forename: Prasad
authors.initials: P
authors.lastname: Vannemreddy
authors.forename: Anil
authors.initials: A
authors.lastname: Nanda
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011836:Radiation Tolerance; D016634:Radiosurgery / Q000295:instrumentation*; D012044:Regression Analysis; D012189:Retrospective Studies; D016019:Survival Analysis