title: Retrospective Study of Metastatic Melanoma and Renal Cell Carcinoma to the Brain with Multivariate Analysis of Prognostic Pre-Treatment Clinical Factors.
abstract: Patients with brain metastasis from renal cell carcinoma (RCC) or melanoma have historically had very poor prognoses of less than one year. Stereotactic radiosurgery (SRS) can be an effective treatment for patients with these tumors. This study analyzes the effect of pretreatment prognostic factors on overall survival (OS) for RCC and melanoma patients with metastasis to the brain treated with SRS. A total of 122 patients with brain metastases from either RCC or melanoma were grouped by age at brain metastasis diagnosis, whether they received whole brain radiation therapy (WBRT) in addition to SRS, or they underwent surgical resection, Karnofsky Performance Score (KPS), number of brain metastases, and primary tumor. Median survival times for melanoma patients and RCC patients were 8.20 ± 3.06 and 12.70 ± 2.63 months, respectively. Patients with >5 metastases had a significantly shorter median survival time (6.60 ± 2.45 months) than the reference group (1 metastasis, 10.70 ± 13.40 months, p = 0.024). Patients with KPS ≤ 60 experienced significantly shorter survival than the reference group (KPS = 90-100), with median survival times of 5.80 ± 2.46 months (p < 0.001) and 45.20 ± 43.52 months, respectively. We found a median overall survival time of 12.7 and 8.2 months for RCC and melanoma, respectively. Our study determined that a higher number of brain metastases (>5) and lower KPS were statistically significant predictors of a lower OS prognosis.
authors.affiliation: Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. ferrele@uw.edu.|Cancer Care Northwest, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. ferrele@uw.edu.|University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195, USA. ferrele@uw.edu.
authors.forename: Ethan A
authors.initials: EA
authors.lastname: Ferrel
authors.affiliation: Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. roehriat@uw.edu.|Cancer Care Northwest, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. roehriat@uw.edu.|University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195, USA. roehriat@uw.edu.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Roehrig
authors.affiliation: Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. erinkaya@berkeley.edu.|Cancer Care Northwest, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. erinkaya@berkeley.edu.
authors.forename: Erin A
authors.initials: EA
authors.lastname: Kaya
authors.affiliation: Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. jonathan.carlson@providence.org.|Inland Neurosurgery &amp; Spine Associates, 105 W 8th Ave, Suite 200, Spokane, WA 99204, USA. jonathan.carlson@providence.org.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Carlson
authors.affiliation: Inland Neurosurgery &amp; Spine Associates, 105 W 8th Ave, Suite 200, Spokane, WA 99204, USA. benjamin.ling@providence.org.
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Ling
authors.affiliation: Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. aaron.wagner@ccnw.net.|Cancer Care Northwest, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. aaron.wagner@ccnw.net.
authors.forename: Aaron
authors.initials: A
authors.lastname: Wagner
authors.affiliation: Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. gkspokane@armackay.net.|Cancer Care Northwest, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. gkspokane@armackay.net.
authors.forename: Alexander R
authors.initials: AR
authors.lastname: MacKay
authors.affiliation: Cancer Care Northwest, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. jason.call@ccnw.net.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Call
authors.affiliation: Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. jdemakas@rockwoodclinic.com.|Rockwood Clinic, 801 W. 5th Ave, Suite 525, Spokane, WA 99204, USA. jdemakas@rockwoodclinic.com.
authors.forename: John J
authors.initials: JJ
authors.lastname: Demakas
authors.affiliation: Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. wayne.lamoreaux@ccnw.net.|Cancer Care Northwest, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. wayne.lamoreaux@ccnw.net.
authors.forename: Wayne T
authors.initials: WT
authors.lastname: Lamoreaux
authors.affiliation: Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. fairbrk@ccnw.net.|Cancer Care Northwest, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. fairbrk@ccnw.net.
authors.forename: Robert K
authors.initials: RK
authors.lastname: Fairbanks
authors.affiliation: Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. bo@gkspokane.com.
authors.forename: Barton S
authors.initials: BS
authors.lastname: Cooke
authors.affiliation: DataWorks Northwest, LLC, 3952 N Magnuson St, Coeur D'Alene, ID 83815, USA. benperessini@dataworksnw.com.
authors.forename: Ben
authors.initials: B
authors.lastname: Peressini
authors.affiliation: Gamma Knife of Spokane, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. chris.lee@ccnw.net.|Cancer Care Northwest, 910 W 5th Ave, Suite 102, Spokane, WA 99204, USA. chris.lee@ccnw.net.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Lee
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000532:radiotherapy*; D008875:Middle Aged; D016634:Radiosurgery; D016019:Survival Analysis
keywords: brain metastasis; melanoma; prognostic factors; renal cell carcinoma; stereotactic radiosurgery