title: Stereotactic radiosurgery plays a critical role in enhancing long-term survival in a patient with pancreatic cancer metastatic to the brain.
abstract: BACKGROUND
  Pancreatic cancer is an aggressive disease which metastasizes readily. The presence of brain metastases from pancreatic cancer is rare and it carries a poor prognosis. Our approach to treating these lesions stresses extensive use of stereotactic radiosurgery (SRS), whereas other reports focus on surgical resection.
  
  
  METHODS
  Information regarding the patient's clinical history was extracted from a retrospective review of the medical records and imaging studies. The patient survived seven years after his primary diagnosis of pancreatic cancer, and 36 months after diagnosis of metastatic disease to the brain. In addition to surgical resection and the use of multiple chemotherapeutic agents, the patient received six separate radiosurgery treatments.
  
  
  CONCLUSIONS
  We present a case of brain metastasis from pancreatic cancer that is remarkable for an unusually long survivorship and discuss the utility of SRS along with a multimodality treatment approach for dealing with these cases.
authors.affiliation: Weill Cornell Brain and Spine Center, 525 East 69th Street Starr Pavilion, 651, New York, NY 10065, box 99, U.S.A. scp2002@med.cornell.edu.
authors.forename: Prajwal
authors.initials: P
authors.lastname: Rajappa
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Margetis
authors.forename: Gabriella
authors.initials: G
authors.lastname: Wernicke
authors.forename: Paula
authors.initials: P
authors.lastname: Ginter
authors.forename: William
authors.initials: W
authors.lastname: Cope
authors.forename: David L
authors.initials: DL
authors.lastname: Sherr
authors.forename: Ehud
authors.initials: E
authors.lastname: Lavi
authors.forename: Robert L
authors.initials: RL
authors.lastname: Fine
authors.forename: Theodore H
authors.initials: TH
authors.lastname: Schwartz
authors.forename: Howard
authors.initials: H
authors.lastname: Bruckner
authors.forename: Susan C
authors.initials: SC
authors.lastname: Pannullo
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology*; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000556:secondary / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008279:Magnetic Resonance Imaging; D008297:Male; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000473:pathology*; D016634:Radiosurgery / Q000379:methods*; D016019:Survival Analysis
keywords: Brain metastases; multimodality treatment; pancreatic cancer; stereotactic radiosurgery