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Gamma Knife radiosurgery in the management of brainstem metastases

Jung, Edward W ; Rakowski, Joseph T ; Delly, Fadi ; Jagannathan, Jayant ; Konski, Andre A ; Guthikonda, Murali ; Kim, Harold ; Mittal, Sandeep

Clinical neurology and neurosurgery, 2013-10, Vol.115 (10), p.2023-2028 [Periódico revisado por pares]

Netherlands: Elsevier B.V

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Título:
Gamma Knife radiosurgery in the management of brainstem metastases
Autor: Jung, Edward W ; Rakowski, Joseph T ; Delly, Fadi ; Jagannathan, Jayant ; Konski, Andre A ; Guthikonda, Murali ; Kim, Harold ; Mittal, Sandeep
Assuntos: Adult ; Age ; Aged ; Aged, 80 and over ; Analysis of Variance ; Brain ; Brain Stem Neoplasms - pathology ; Brain Stem Neoplasms - secondary ; Brain Stem Neoplasms - surgery ; Brainstem ; Cancer therapies ; Cervical cancer ; Chemotherapy ; Confidence intervals ; Data Interpretation, Statistical ; Female ; Follow-Up Studies ; Gamma Knife ; Humans ; Kaplan-Meier Estimate ; Karnofsky Performance Status ; Lung cancer ; Male ; Melanoma ; Metastases ; Middle Aged ; Multivariate analysis ; Nervous System Diseases - etiology ; Neurology ; Neurosurgery ; Patients ; Radiation therapy ; Radiosurgery - methods ; Retrospective Studies ; Statistical analysis ; Stereotactic radiosurgery ; Survival Analysis ; Volumetric analysis ; Whole-Body Irradiation
É parte de: Clinical neurology and neurosurgery, 2013-10, Vol.115 (10), p.2023-2028
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Descrição: Abstract Background Metastases to the brainstem portend a poor prognosis and present a challenge in clinical management. Surgical resection is rarely a viable option. Methods Post-treatment MRI scans of patients with brainstem metastases treated with radiosurgery were used to determine local control and disease progression. Median survival was calculated using Kaplan–Meier analysis. Univariate and multivariate analyses were performed using log-rank test and Cox proportional hazards model, respectively. Results Thirty-two consecutive patients with brainstem metastasis underwent Gamma Knife radiosurgery. Median age was 50 years. Median tumor volume was 0.71 cm3 and median tumor margin dose was 13 Gy. Seventeen of 32 patients received WBRT prior to stereotactic radiosurgery. Median survival was 5.2 months. There was a statistically significant difference in survival based on RTOG recursive partition analysis (RPA) class. Median survival of patients categorized as RPA class I was 19.2 months, RPA class II was 8.4 months, and RPA class III was 1.9 months. The overall local tumor control rate was 87.5%. There were no acute complications following stereotactic radiosurgery and no evidence of radiation necrosis noted on post-treatment MRI scans. Conclusion Stereotactic radiosurgery is an effective treatment for brainstem metastases and should be considered especially for patients with good performance status.
Editor: Netherlands: Elsevier B.V
Idioma: Inglês

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Gamma Knife radiosurgery in the management of brainstem metastases

Jung, Edward W ; Rakowski, Joseph T ; Delly, Fadi ; Jagannathan, Jayant ; Konski, Andre A ; Guthikonda, Murali ; Kim, Harold ; Mittal, Sandeep

Netherlands: Elsevier B.V

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