title: Radiosurgery with 20 Gy provides better local contol of 1-3 brain metastases from breast cancer than with lower doses.
abstract: OBJECTIVE
  To determine the optimal dose of radiosurgery-alone for patients with 1-3 cerebral metastases from breast cancer.
  
  
  METHODS
  Patients receiving 20 Gy (n=20) were compared to those receiving 16-18.5 Gy (n=10) for local control, distant brain control and overall survival. Seven other variables were also evaluated.
  
  
  RESULTS
  Radiosurgery dose achieved significance on univariate (p=0.002; log-rank and Wilcoxon test) and multivariate analysis (p=0.004) of local control. Twelve-month local control rates were 94% after 20 Gy and 48% after 16-18.5 Gy. On univariate analysis of distant brain control, radiosurgery dose was not a significant factor, with 12-month rates of 73% and 60%, respectively. Regarding overall survival, radiosurgery dose was of borderline significance (p=0.059; Wilcoxon test). Twelve-month overall survival rates were 75% and 40%, respectively. On Cox regression analysis, radiosurgery dose exhibited a trend for improving survival (p=0.10).
  
  
  CONCLUSIONS
  Radiosurgery with 20 Gy resulted in significantly better local control and led to a trend towards improved overall survival compared to treatment with 16-18.5 Gy.
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: Stefan
authors.initials: S
authors.lastname: Huttenlocher
authors.affiliation: Department of Radiation Oncology, Saad Specialist Hospital, Al Khobar, Saudi Arabia.
authors.forename: Volker
authors.initials: V
authors.lastname: Rudat
authors.affiliation: Department of Radiation Oncology, University Medical Center Eppendorf, Hamburg, Germany.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Hornung
authors.affiliation: CyberKnife Centre Northern Germany, Güstrow, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Blanck
authors.affiliation: Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Pham Cam
authors.initials: PC
authors.lastname: Phuong
authors.affiliation: Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Mai Trong
authors.initials: MT
authors.lastname: Khoa
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: Department of Gynecology and Obstetrics, University of Lübeck, Lübeck, Germany.
authors.forename: Dorothea
authors.initials: D
authors.lastname: Fischer
mesh_terms: D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D016016:Proportional Hazards Models; D016634:Radiosurgery; D011879:Radiotherapy Dosage; D047368:Tumor Burden
keywords: Breast cancer; brain metastasis; distant brain control; local control; overall survival; radiation dose; radiosurgery