title: Identifying melanoma patients with 1-3 brain metastases who may benefit from whole-brain irradiation in addition to radiosurgery.
abstract: OBJECTIVE
  To develop a tool for estimating the risk of developing new cerebral lesions in 69 melanoma patients receiving radiosurgery for 1-3 cerebral metastases.
  
  
  METHODS
  Ten factors were investigated: lactate dehydrogenase (LDH), radiosurgery dose, age, gender, performance status, maximum diameter, location and number of cerebral lesions, extra-cranial spread, time between melanoma diagnosis and radiosurgery. Two factors, number of lesions and extra-cranial spread, were included in the tool. Scoring points were achieved by dividing the 6-month rate of freedom from new cerebral lesions by 10.
  
  
  RESULTS
  Sum scores were 9, 11, 12 or 14 points. Six-month rates of freedom from new brain metastases were 28%, 63%, 59% and 92% (p=0.002). Three prognostic groups were designed: A (9 points), B (11-12 points) and C (14 points). Freedom from new cerebral lesion rates were 28%, 60% and 92% (p<0.001).
  
  
  CONCLUSIONS
  Group A and B patients should be considered for additional whole-brain radiotherapy (WBRT).
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.
authors.forename: Lena
authors.initials: L
authors.lastname: Sehmisch
authors.affiliation: Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Schild
authors.affiliation: CyberKnife Centre 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 Radiation Oncology, University of Lübeck, Lübeck, Germany rades.dirk@gmx.net.
authors.forename: Dirk
authors.initials: D
authors.lastname: Rades
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000628:therapy*; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D011379:Prognosis; D016634:Radiosurgery; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Radiosurgery; melanoma; new brain metastases; predictive score; whole-brain irradiation