LINAC-based radiosurgery for melanoma, sarcoma and renal cell carcinoma brain metastases.
BACKGROUND
The aim of this study was to report response, overall survival (OS) and toxicity in patients with radioresistant brain metastases (BM) treated with stereotactic radiosurgery (SRS).


METHODS
Patients with renal cell carcinoma, melanoma and sarcoma with one to four brain metastases received SRS without whole brain radiotherapy.


RESULTS
Fifty patients with 77 BM were treated. 46 (92%) patients with 71 BM were evaluable. Median follow-up was 67 months and median OS 11.8 months. At the time of analysis all patients had died. Brain control was conditioned by response to SRS (P<0.0001), while OS by histology (renal cell carcinoma versus melanoma and sarcoma) (P=0.04) and status of the tumour outside the brain (P=0.05). Treatment was well tolerated without more than grade 2 acute toxicity.


CONCLUSIONS
Treatment of BM from radioresistant tumors with SRS assures good brain control and OS with low toxicity. Our data suggest a better prognosis associated to renal cell carcinoma histology.
Radiotherapy Oncology Center, S. Maria Hospital, Terni, Italy - e.maranzano@aospterni.it.
Ernesto
E
Maranzano
Radiotherapy Oncology Center, S. Maria Hospital, Terni, Italy.
Michelina
M
Casale
Radiotherapy Oncology Center, S. Maria Hospital, Terni, Italy.|Neurosurgery Center, S. Maria Hospital, Terni, Italy.
Rossella
R
Rispoli
Radiotherapy Oncology Center, S. Maria Hospital, Terni, Italy.
Fabio
F
Trippa
Radiotherapy Oncology Center, S. Maria Hospital, Terni, Italy.
Lorena
L
Draghini
Radiotherapy Oncology Center, S. Maria Hospital, Terni, Italy.
Fabio
F
Arcidiacono
Radiotherapy Oncology Center, S. Maria Hospital, Terni, Italy.|Neurosurgery Center, S. Maria Hospital, Terni, Italy.
Sandro
S
Carletti
Radiotherapy Oncology Center, S. Maria Hospital, Terni, Italy.
Paola
P
Anselmo
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D002292:Carcinoma, Renal Cell / Q000532:radiotherapy / Q000556:secondary; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000532:radiotherapy / Q000556:secondary; D008875:Middle Aged; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies; D012509:Sarcoma / Q000532:radiotherapy / Q000556:secondary; D016896:Treatment Outcome; D055815:Young Adult