Radiosurgery alone for 1-3 newly-diagnosed brain metastases from melanoma: impact of dose on treatment outcomes

To compare different doses of stereotactic radiosurgery (SRS) for 1-3 newly-diagnosed cerebral metastases from melanoma. Fifty-four patients were assigned to dose groups of 20 Gy (N=36) and 21-22.5 Gy (N=18). Variables additionally analyzed were age, gender, Karnofsky Performance Score (KPS), lactat...

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Bibliographic Details
Published in:Anticancer research 2014-09, Vol.34 (9), p.5079-5082
Main Authors: Rades, Dirk, Sehmisch, Lena, Huttenlocher, Stefan, Blank, Oliver, Hornung, Dagmar, Terheyden, Patrick, Gliemroth, Jan, Schild, Steven E
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Brain Neoplasms - mortality
Brain Neoplasms - pathology
Brain Neoplasms - secondary
Brain Neoplasms - surgery
Female
Humans
Male
Melanoma - pathology
Middle Aged
Prognosis
Radiation Dosage
Radiosurgery
Retrospective Studies
Treatment Outcome
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Summary:To compare different doses of stereotactic radiosurgery (SRS) for 1-3 newly-diagnosed cerebral metastases from melanoma. Fifty-four patients were assigned to dose groups of 20 Gy (N=36) and 21-22.5 Gy (N=18). Variables additionally analyzed were age, gender, Karnofsky Performance Score (KPS), lactate dehydrogenase (LDH) before SRS, number of cerebral lesions, extracranial lesions, time from melanoma diagnosis to SRS. The 12-month local control was 72% after 20 Gy and 100% after 21-22.5 Gy (p=0.020). Freedom from new cerebral metastases (p=0.13) and survival (p=0.13) showed no association with SRS dose. On multivariate analyses, improved local control showed significant associations with SRS doses of 21-22.5 Gy (p=0.007) and normal lactate dehydrogenase levels (p=0.018). Improved survival was associated with normal LDH levels (p=0.006) and KPS 90-100 (p=0.046). SRS doses of 21-22.5 Gy resulted in better local control than 20 Gy. Freedom from new brain metastases and survival were not significantly different.
ISSN:1791-7530