title: Local Therapies Can Improve Intracerebral Control in Patients with Cerebral Metastasis from Gynecological Cancers.
abstract: Patients with gynecological malignancies account for 2% of patients with cerebral metastases. Many patients receive whole-brain irradiation (WBI) alone. Local therapies (resection, stereotactic radiosurgery (SRS)) are becoming more popular. This study compared intracerebral control after local therapy to WBI alone in patients with gynecological malignancies.
  
  
  
  Of 56 patients, 45 received WBI alone, 6 SRS alone and 5 resection plus WBI. Treatment type, age, performance score, cancer site, number of cerebral lesions, metastases outside the brain, recursive partitioning analysis (RPA) class and period from gynecological cancer diagnosis to brain metastasis treatment were evaluated.
  
  
  
  On univariate analyses, local therapy (p=0.003), single cerebral lesion (p<0.001) and RPA class 1/2 (p=0.027) were positively related to intracerebral control. On Cox regression analysis, local therapy (p=0.013) and RPA class 1/2 (p=0.014) were significant.
  
  
  
  Local therapies led to better intracerebral control than WBI alone and should be considered for brain metastasis from gynecological malignancies whenever reasonable.
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
authors.forename: Liesa
authors.initials: L
authors.lastname: Dziggel
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany Medical Practice for Radiotherapy and Radiation Oncology, Hannover, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Janssen
authors.affiliation: Department of Radiotherapy, University Medical Center Eppendorf, Hamburg, Germany.
authors.forename: Amira
authors.initials: A
authors.lastname: Bajrovic
authors.affiliation: Department of Radiotherapy, Dr. Bernard Verbeeten Institute, Tilburg, the Netherlands.
authors.forename: Theo
authors.initials: T
authors.lastname: Veninga
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 Department of Nuclear Mediciume, Hanoi Medical University, 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 Radiation Oncology, University of Lübeck, Lübeck, Germany rades.dirk@gmx.net.
authors.forename: Dirk
authors.initials: D
authors.lastname: Rades
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology / Q000528:radiation effects / Q000601:surgery; D001932:Brain Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery*; D002540:Cerebral Cortex / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D016634:Radiosurgery; D016896:Treatment Outcome
keywords: Gynecological cancers; cerebral metastasis; intracerebral control; neurosurgical resection; stereotactic radiosurgery; whole-brain irradiation