title: Gamma Knife Surgery for Metastatic Brain Tumors from Gynecologic Cancer.
abstract: OBJECTIVE
  The incidences of metastatic brain tumors from gynecologic cancer have increased. The results of Gamma Knife surgery (GKS) for the treatment of patients with brain metastases from gynecologic cancer (ovarian, endometrial, and uterine cervical cancers) were retrospectively analyzed to identify the efficacy and prognostic factors for local tumor control and survival.
  
  
  METHODS
  The medical records were retrospectively reviewed of 70 patients with 306 tumors who underwent GKS for brain metastases from gynecologic cancer between January 1995 and December 2013 in our institution.
  
  
  RESULTS
  The primary cancers were ovarian in 33 patients with 147 tumors and uterine in 37 patients with 159 tumors. Median tumor volume was 0.3 cm(3). Median marginal prescription dose was 20 Gy. The local tumor control rates were 96.4% at 6 months and 89.9% at 1 year. There was no statistically significant difference between ovarian and uterine cancers. Higher prescription dose and smaller tumor volume were significantly correlated with local tumor control. Median overall survival time was 8 months. Primary ovarian cancer, controlled extracranial metastases, and solitary brain metastasis were significantly correlated with satisfactory overall survival. Median activities of daily living (ADL) preservation survival time was 8 months. Primary ovarian cancer, controlled extracranial metastases, and higher Karnofsky Performance Status score were significantly correlated with better ADL preservation.
  
  
  CONCLUSIONS
  GKS is effective for control of tumor progression in patients with brain metastases from gynecologic cancer, and may provide neurologic benefits and preservation of the quality of life.
authors: Department of Neurosurgery, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan. Electronic address: shigeo-m@mui.biglobe.ne.jp.
authors: Shigeo
authors: S
authors: Matsunaga
authors: Department of Neurosurgery, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan.
authors: Takashi
authors: T
authors: Shuto
authors: Department of Neurosurgery, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan.
authors: Mitsuru
authors: M
authors: Sato
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000601:surgery; D001932:Brain Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery*; D005260:Female; D005833:Genital Neoplasms, Female / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D008875:Middle Aged; D011379:Prognosis; D016634:Radiosurgery; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult
keywords: Brain metastases; Gamma Knife; Gynecologic cancer; Ovarian cancer; Stereotactic radiosurgery; Uterus cancer