title: Radiosurgery alone for 1-3 newly-diagnosed brain metastases from melanoma: impact of dose on treatment outcomes.
abstract: OBJECTIVE
  To compare different doses of stereotactic radiosurgery (SRS) for 1-3 newly-diagnosed cerebral metastases from melanoma.
  
  
  METHODS
  Fifty-four patients were assigned to dose groups of 20 Gy (N=36) and 21-22.5 Gy (N=18). Variables additionally analyzed were age, gender, Karnofsky Performance Score (KPS), lactate dehydrogenase (LDH) before SRS, number of cerebral lesions, extracranial lesions, time from melanoma diagnosis to SRS.
  
  
  RESULTS
  The 12-month local control was 72% after 20 Gy and 100% after 21-22.5 Gy (p=0.020). Freedom from new cerebral metastases (p=0.13) and survival (p=0.13) showed no association with SRS dose. On multivariate analyses, improved local control showed significant associations with SRS doses of 21-22.5 Gy (p=0.007) and normal lactate dehydrogenase levels (p=0.018). Improved survival was associated with normal LDH levels (p=0.006) and KPS 90-100 (p=0.046).
  
  
  CONCLUSIONS
  SRS doses of 21-22.5 Gy resulted in better local control than 20 Gy. Freedom from new brain metastases and survival were not significantly different.
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany Rades.Dirk@gmx.net.
authors.forename: Dirk
authors.initials: D
authors.lastname: Rades
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
authors.forename: Lena
authors.initials: L
authors.lastname: Sehmisch
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Huttenlocher
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany CyberKnife Center Northern Germany, Güstrow, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Blank
authors.affiliation: Department of Radiation Oncology, University Medical Center Eppendorf, Hamburg, Germany.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Hornung
authors.affiliation: Department of Dermatology, University of Lübeck, Lübeck, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Terheyden
authors.affiliation: Department of Neurosurgery, University of Lübeck, Lübeck, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Gliemroth
authors.affiliation: Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Schild
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D011379:Prognosis; D011829:Radiation Dosage; D016634:Radiosurgery; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Melanoma; brain metastases; radiosurgery