Journal of Korean Neurosurgical Society

  • 제46권3호
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  • Pages.245-251
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  • 2009
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Clinical Analysis of Novalis Stereotactic Radiosurgery for Brain Metastases

  • Gu, Hae-Won (Department of Neurosurgery, Novalis Radiosurgery Center, Inje University College of Medicine, Ilsan Paik Hospital) ;
  • Sohn, Moon-Jun (Department of Neurosurgery, Novalis Radiosurgery Center, Inje University College of Medicine, Ilsan Paik Hospital) ;
  • Lee, Dong-Joon (Department of Neurosurgery, Novalis Radiosurgery Center, Inje University College of Medicine, Ilsan Paik Hospital) ;
  • Lee, Hye-Ran (Department of Internal Medicine, Novalis Radiosurgery Center, Inje University College of Medicine, Ilsan Paik Hospital) ;
  • Lee, Chae-Heuck (Department of Neurosurgery, Novalis Radiosurgery Center, Inje University College of Medicine, Ilsan Paik Hospital) ;
  • Whang, C.-Jin (Department of Neurosurgery, Novalis Radiosurgery Center, Inje University College of Medicine, Ilsan Paik Hospital)
  • 발행 : 2009.09.28
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초록

Objective : The authors analyzed the effectiveness and therapeutic response of Novalis shaped beam radiosurgery for metastatic brain tumors, and the prognostic factors which influenced the outcome. Methods : We performed a retrospective analysis of 106 patients who underwent 159 treatments for 640 metastatic brain lesions between January 2000 and April 2008. The pathologies of the primary tumor were mainly lung (45.3%), breast (18.2%) and GI tract (13.2%). We classified the patients using Radiation Therapy Oncology Group Recursive Partitioning Analysis (RPA) and then analyzed the survival and prognostic factors according to the Kaplan Meier method and univariate analysis. Results : The overall median actuarial survival rate was 7.3 months from the time of first radiosurgery treatment while 1 and 2 year actuarial survival estimates were 31% and 14.4%, respectively. Median actuarial survival rates for RPA classes I, II, and III were 31.3 months, 7.5 months and 1.7 months, respectively. Patients' life spans, higher Karnofsky performance scores and age correlated closely with RPA classes. However, sex and the number of lesions were not found to be significantly associated with length of survival. Conclusion : This result suggests that Novalis radiosurgery can be a good treatment option for treatment of the patients with brain metastases.

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참고문헌

  1. Adler JR, Cox RS, Kaplan I, Martin DP : Stereotactic radiosurgical treatment of brain metastases. J Neurosurg 76 : 444-449, 1992 https://doi.org/10.3171/jns.1992.76.3.0444
  2. Chen JC, Petrovich Z, Giannotta SL, Yu C, Apuzzo ML : Radiosurgical salvage therapy for patients presenting with recurrence of metastatic disease to the brain. Neurosurgery 46 : 860-866; discussion 866-867, 2000 https://doi.org/10.1097/00006123-200004000-00017
  3. Chen JC, Petrovich Z, O’day S, Morton D, Essner R, Giannotta SL, et al. : Stereotactic radiosurgery in the treatment of metastatic disease to the brain. Neurosurgery 47 : 268-279; discussion 279-281, 2000 https://doi.org/10.1097/00006123-200008000-00003
  4. Chidel MA, Suh JH, Reddy CA, Chao ST, Lundbeck MF, Barnett GH : Application of recursive partitioning analysis and evaluation of the use of whole brain radiation among patients treated with stereotactic radiosurgery for newly diagnosed brain metastases. Int J Radiat Oncol Biol Phys 47 : 993-999, 2000 https://doi.org/10.1016/S0360-3016(00)00527-7
  5. Coia LR : The role of radiation therapy in the treatment of brain metastases. Int J Radiat Oncol Biol Phys 23 : 229-238, 1992 https://doi.org/10.1016/0360-3016(92)90567-2
  6. DeAngelis LM, Delattre JY, Posner JB : Radiation-induced dementia in patients cured of brain metastases. Neurology 39 : 789-796, 1989 https://doi.org/10.1212/WNL.39.6.789
  7. Deinsberger R, Tidstrand J : LINAC Radiosurgery as single treatment in cerebral metastases. J Neurooncol 76 : 77-83, 2006 https://doi.org/10.1007/s11060-005-3669-3
  8. Gaspar L, Scott C, Rotman M, Asbell S, Phillips T, Wasserman T, et al. : Recursive Partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 37 : 745-751, 1997 https://doi.org/10.1016/S0360-3016(96)00619-0
  9. Hasegawa T, Kondziolka D, Flickinger JC, Germanwala A, Lunsford LD : Brain metastases treated with radiosurgery alone : an alternative to whole brain radiotherapy? Neurosurgery 52 : 1318-1326; discussion 1326, 2003 https://doi.org/10.1227/01.NEU.0000064569.18914.DE
  10. Klein M, Taphoorn MJ, Heimans JJ, van der Ploeg HM, Vandertop WP, Smit EF, et al. : Neurobehavioral status and health-related quality of life in newly diagnosed high-grade glioma patients. J Clin Oncol 19 : 4037-4047, 2001 https://doi.org/10.1200/JCO.2001.19.20.4037
  11. Kramer S : The hazards of therapeutic iradiation of the central nervous system. Clin Neurosurg 15 : 301-318, 1968 https://doi.org/10.1093/neurosurgery/15.CN_suppl_1.301
  12. Laack NN, Brown PD : Cognitive sequelae of brain radiation in adults. Semin Oncol 31 : 702-713, 2004 https://doi.org/10.1053/j.seminoncol.2004.07.013
  13. Lang FF, Sawaya R : Surgical management of cerebral metastases. Neurosurg Clin N Am 7 : 459-484, 1996
  14. Lavine SD, Petrovich Z, Cohen-Gadol AA, Masri LS, Morton DL, O'Day SJ, et al. : Gamma knife radiosurgery for metastatic melanoma : an analysis of survival, outcome, and complications. Neurosurgery 44 : 59-64; discussion 64 66, 1999 https://doi.org/10.1097/00006123-199901000-00031
  15. Lee HJ, Posner JB : Radiosurgery for metastases from malignant melanoma. Cancer J Sci Am 4 : 80-83, 1998
  16. Lutterbach J, Cyron D, Henne K, Ostertag CB : Radiosurgery followed by planned observation in patients with one to three brain metastases. Neurosurgery 52 : 1066-1073; discussion 1073-1074, 2003 https://doi.org/10.1227/01.NEU.0000057695.46198.FE
  17. O'Neill BP, Iturria NJ, Link MJ, Pollock BE, Ballman KV, O'Fallon JR : A comparison of surgical resection and stereotactic radiosurgery in the treatment of solitary brain metastases. Int J Radiat Oncol Biol Phys 55 : 1169-1176, 2003 https://doi.org/10.1016/S0360-3016(02)04379-1
  18. Paek SH, Audu PB, Sperling MR, Cho J, Andrews DW : Reevaluation of surgery for the treatment of brain metastases : review of 208 patients with single of multiple brain metastases treated at one institution with modern neurosurgical techniques. Neurosurgery 56 : 1021-1034; discussion 1021-1034, 2005
  19. Patchell RA, Tibbs PA, Walsh JW, Dempsey RJ, Maruyama Y, Kryscio RJ, et al. : A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 322 : 494-500, 1990 https://doi.org/10.1056/NEJM199002223220802
  20. Petrovich Z, Yu C, Giannotta SL, O'Day S, Apuzzo ML : Survival and pattern of failure in brain metastasis treated with stereotactic gamma knife radiosurgery. J Neurosurg 97 (5 Suppl) : 499-506, 2002
  21. Phillips TL, Scott CB, Leibel SA, Rotman M, Weigensberg IJ : Results of a randomized comparison of radiotherapy and bromodeoxyuridine with radiotherapy alone for brain metastases : report of RTOG trial 89-05. Int J Radiat Oncol Biol Phys 33 : 339-348, 1995 https://doi.org/10.1016/0360-3016(95)00168-X
  22. Pollock BE: Management of Patients with Multiple Brain Metastases. Cont Neurosurg 21 : 1-6, 1999
  23. Posner JB, Chernik NL : Intracranial metastases from systemic cancer. Adv Neurol 19 : 579-592, 1978
  24. Rades D, Pluemer A, Veninga T, Hanssens P, Dunst J : Whole-brain radiotherapy versus stereotactic radiosurgery for patients in resursive partitioning analysis classes 1 and 2 with 1 to 3 brain metastases. Cancer 110 : 2285-2292, 2007 https://doi.org/10.1002/cncr.23037
  25. Schöggl A, Kitz K, Reddy M, Wolfsberger S, Schneider B, Dieckmann K, et al. : Defining the role of stereotactic radiosurgery versus microsurgery in the treatment of single brain metastases. Acta Neurochir (Wien) 142 : 621-626, 2000 https://doi.org/10.1007/s007010070104
  26. Seung SK, Sneed PK, McDermott MW, Shu HK, Leong SP, Chang S, et al. : Gamma knife radiosurgery for malignant melanoma brain metastases. Cancer J Sci Am 4 : 103-109, 1998
  27. Sneed PK, Lamborn KR, Forstner JM, McDermott MW, Chang S, Park E, et al. : Radiosurgery for brain metastases: is whole brain radiotherapy necessary? Int J Radiat Oncol Biol Phys 43 : 549-558, 1999 https://doi.org/10.1016/S0360-3016(98)00447-7
  28. Sperduto P, Sneed P, Bhatt A, Schwer A, Fiveash J, Chiang V, et al. : A Multi-institutional Validation Study of a New Prognostic Indes (Graded Prognostic Assessment, GPA) for Patients with Brain Metastases. Int J Radiat Oncol Biol Phys 70 : 510-514, 2008 https://doi.org/10.1016/j.ijrobp.2007.06.074
  29. Weissman DE : Glucocorticoid treatment for brain metastases and epidural spinal cord compression : a review. J Clin Oncol 6 : 543-551, 1988 https://doi.org/10.1200/JCO.1988.6.3.543
  30. Weltman E, Salvajoli JV, Brandt RA, de Morais Hanriot R, Prisco FE, Cruz JC, et al. : Radiosurgery for brain metastases : a score index for predicting prognosis. Int J Radiat Oncol Biol Phys 46 : 1155-1161 , 2000 https://doi.org/10.1016/S0360-3016(99)00549-0
  31. Yu C, Chen JC, Apuzzo ML, O’Day S, Giannotta SL, Weber JS, et al : Metastatic melanoma to the brain : prognostic factors after gamma knife radiosurgery. Int J Radiat Oncol Biol Phys 52 : 1277-1287, 2002 https://doi.org/10.1016/S0360-3016(01)02772-9

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