 |
| Research article summary (published 27 Feb 2009): |
Early brain tumor metastasis reduction following Gamma Knife surgery.
Full Abstract
OBJECT: Unlike whole-brain radiation therapy, Gamma Knife surgery (GKS) is delivered in a single session for the treatment of brain metastases. The extent to which GKS can facilitate early tumor control was the focus of this study. METHODS: The authors reviewed 134 metastatic lesions in 82 patients treated with GKS at the University of Virginia who underwent follow-up MR imaging within 30 days or less of GKS. For accurate volumetry only tumors measuring 0.5 cm3 or greater in volume were included. Radiological review as well as tumor volumetry was performed to assess the tumor's response to GKS. Tumors were characterized as either enlarged (> 15% volume increase), stable (follow-up volume +/- 15% of the initial volume), or decreased (> 15% volume decrease). A multivariate analysis was performed to determine factors related to each volume outcome group. RESULTS: Within the first month following GKS, a decrease was observed in 47.8% of the tumors. Tumor reduction varied according to carcinoma histopathological subtype, with 46.4% of non-small cell lung carcinomas, 70% of breast carcinomas, and 22.6% of melanomas showing volume reduction within 30 days after GKS. The mean volume decrease was 41.7%. For the remaining tumors, 41% were stable and 11.2% increased in volume. The overall analysis showed that there was a significant difference in percentage tumor change according to histopathological type (p < 0.001). There was a trend toward increased tumor reduction in those carcinoma types that are traditionally viewed as radiation sensitive (breast and non-small cell lung carcinomas). CONCLUSIONS: Gamma Knife surgery can offer patients early substantial volume reduction in many brain metastases. In instances in which early volume reduction of limited intracranial disease is desired, GKS may be used alone or before whole brain radiation therapy.
Author information
Author/s: Da Silva, Arnaldo Neves (AN); Nagayama, Kazuki (K); Schlesinger, David (D); Sheehan, Jason P (JP);
Affiliation: The Lars Leksell Gamma Knife Center, Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia 22908, USA.
Journal and publication information
Publication Type: Journal Article
Journal: Journal of neurosurgery (J Neurosurg), published in United States. (Language: eng)
Reference: 2009-Mar; vol 110 (issue 3) : pp 547-52
Dates: Created 2009/03/19; Completed 2009/04/07;
PMID: 18821832, status: MEDLINE (last retrieved date: 4/7/2009)
Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.
External Links for this article
(including full text providers, if available):
Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.
This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.
MeSH headings (categories)
This article was linked to the MeSH Headings (categories) shown below.
Note: Bold headings indicate primary MeSH headings or qualifiers.
Related articles
This article has not been indexed for related articles as yet, however you can still use the live related article search links below.
See a larger map of 100+ related articles.