title: Radiosurgery to palliate symptoms in brain metastases from uterine cervix cancer.
abstract: BACKGROUND
  The optimal management of brain metastases from uterine cervix cancer (UCC) is not well defined because of the rarity of the condition and the scarcity of published reports. Here we report our experience with stereotactic radiosurgery for the management of brain metastases from UCC.
  
  
  METHODS
  Thirteen consecutive patients with brain metastases from UCC were managed with a Leksell gamma-knife at our institution between January 2003 and December 2010. Clinical features and radiosurgical outcomes of patients were analyzed retrospectively.
  
  
  RESULTS
  Gamma-knife radiosurgery (GKRS) was chosen as the only treatment in four patients and performed in combination with whole-brain radiotherapy (WBRT) in nine patients. GKRS was conducted simultaneously with WBRT within a 1-month interval in six patients and was chosen as the salvage treatment after WBRT in three patients. The mean number of metastatic brain lesions per patient was 5.7 (range, 1-16). The median cumulative tumor volume was 23.7 cm(3) (range, 2.7-40.2 cm(3)), and the median marginal dose covering the tumors was 14 Gy of a 50 % isodose line (range, 8-25 Gy). Nine patients showed relief of main neurologic symptoms after GKRS. The median length of time that the patients spent in an improved neurologic state was 11.1 weeks (range, 2-39.6 weeks). The local and distant control rates were 66.7 % and 77.8 %, respectively. The median survival from the date of GKRS until death was 4.6 months (range, 1.0-15.9 months). The 6-month and 12-month survival rates after GKRS were 38 and 15 %, respectively.
  
  
  CONCLUSIONS
  GKRS could be an efficient palliative measure to relieve neurologic symptoms caused by brain metastasis from UCC.
authors.affiliation: Department of Neurosurgery, National Medical Center, 245 Eulgi-ro, Jung-gu, Seoul, 100-799, Republic of Korea. phoenixchung@hanmail.net
authors.forename: Sang-Bong
authors.initials: SB
authors.lastname: Chung
authors.forename: Kyung-Il
authors.initials: KI
authors.lastname: Jo
authors.forename: Ho-Jun
authors.initials: HJ
authors.lastname: Seol
authors.forename: Do-Hyun
authors.initials: DH
authors.lastname: Nam
authors.forename: Jung-Il
authors.initials: JI
authors.lastname: Lee
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery*; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery*; D018288:Carcinoma, Small Cell / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery*; D059186:Chemoradiotherapy, Adjuvant; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D016634:Radiosurgery; D018714:Radiotherapy, Adjuvant; D056910:Republic of Korea; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*