title: Impact of stereotactic radiosurgery dose on control of cerebral metastases from renal cell carcinoma.
abstract: OBJECTIVE
  Renal cell carcinoma (RCC) is a relatively radioresistant tumor and may require for higher radiation doses than other tumor types.
  
  
  METHODS
  Nineteen patients treated with 20 Gy of stereotactic radiosurgery (SRS) alone for one to three cerebral metastases were compared to nine patients treated with 16-18 Gy.
  
  
  RESULTS
  SRS with 20 Gy led to significantly better local control than did 16-18 Gy (81% vs. 50% at 12 months; p<0.001). Results were also significant on multivariate analysis (risk ratio: 6.30; p=0.033). SRS dose did not associate with freedom from new cerebral metastases (75% vs. 62% at 12 months; p=0.42) or survival (16% vs. 56% at 12 months; p=0.46). On multivariate analyses, better survival was associated with higher Karnofsky performance score (p<0.001) and absence of extracranial metastatic disease (p=0.006).
  
  
  CONCLUSIONS
  In patients treated with SRS alone, local control of cerebral metastases from RCC was better after 20 Gy than after 16-18 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 Medical Oncology, University of Lübeck, Lübeck, Germany.
authors.forename: Niklas
authors.initials: N
authors.lastname: Gebauer
authors.affiliation: Department of Radiation Oncology, University Medical Center Eppendorf, Hamburg, Germany.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Hornung
authors.affiliation: Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Ngo Thuy
authors.initials: NT
authors.lastname: Trang
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
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology* / Q000556:secondary; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000473:pathology* / Q000556:secondary; D016016:Proportional Hazards Models; D016634:Radiosurgery / Q000009:adverse effects*; D011879:Radiotherapy Dosage
keywords: cerebral metastases; freedom from new cerebral metastases; local control; renal cell carcinoma; stereotactic radiosurgery; survival