eprintid: 19400
rev_number: 15
eprint_status: archive
userid: 1589
dir: disk0/00/01/94/00
datestamp: 2015-12-15 10:13:19
lastmod: 2024-03-18 23:18:56
status_changed: 2015-12-15 10:13:19
type: article
metadata_visibility: show
creators_name: Hauswald, Henrik
creators_name: Stenke, Alina
creators_name: Debus, Jürgen
creators_name: Combs, Stephanie E.
title: Linear accelerator-based stereotactic radiosurgery in 140 brain metastases from malignant melanoma
subjects: ddc-610
divisions: i-911400
abstract: Background: To retrospectively access outcome and prognostic parameters of linear accelerator-based stereotactic radiosurgery in brain metastases from malignant melanoma.   Methods: Between 1990 and 2011 140 brain metastases in 84 patients with malignant melanoma (median age 56 years) were treated with stereotactic radiosurgery. At initial stereotactic radiosurgery 48 % of patients showed extracerebral control. The median count of brain metastases in a single patient was 1, the median diameter was 12 mm. The median dose applied was 20 Gy/80 % isodose enclosing.   Results: The median follow-up was 7 months and the median overall survival 9 months. The 6-, 12- and 24 month overall survival rates were 71 %, 39 % and 25 % respectively. Cerebral follow-up imaging showed complete remission in 20 brain metastases, partial remission in 39 brain metastases, stable disease in 54 brain metastases, progressive disease in 24 brain metastases and pseudo-progression in 3 brain metastases. Median intracerebral control was 5.3 months and the 6- and 12-month intracerebral progression-free survival rates 48 % and 38 %, respectively. Upon univariate analysis, extracerebral control (log-rank, p < 0.001), the response to stereotactic radiosurgery (log-rank, p < 0.001), the number of brain metastases (log-rank, p = 0.007), the recursive partitioning analysis class (log-rank, p = 0.027) and the diagnosis-specific graded prognostic assessment score (log-rank, p = 0.011) were prognostic for overall survival. The most common clinical side effect was headache common toxicity criteria grade I. The most common radiological finding during follow-up was localized edema within the stereotactic radiosurgery high dose region.   Conclusion: Stereotactic radiosurgery is a well-tolerated and effective treatment option for brain metastases in malignant melanoma and was able to achieve local remissions in several cases. Furthermore, especially patients with controlled extracerebral disease and a low count of brain metastases seem to benefit from this treatment modality. Prospective trials analysing the effects of combined stereotactic radiosurgery and new systemic agents are warranted.  
date: 2015
publisher: BioMed Central
id_scheme: DOI
ppn_swb: 1654890650
own_urn: urn:nbn:de:bsz:16-heidok-194003
language: eng
bibsort: HAUSWALDHELINEARACCE2015
full_text_status: public
publication: BMC cancer
volume: 15
number: 537
place_of_pub: London
pagerange: 1-7
issn: 1471-2407
citation:   Hauswald, Henrik ; Stenke, Alina ; Debus, Jürgen ; Combs, Stephanie E.  (2015) Linear accelerator-based stereotactic radiosurgery in 140 brain metastases from malignant melanoma.  BMC cancer, 15 (537).  pp. 1-7.  ISSN 1471-2407     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/19400/1/12885_2015_Article_1517.pdf