Stereotactic radiosurgery for brain metastasis from renal cell carcinoma

Yoshimasa Mori, Douglas Kondziolka, John C. Flickinger, Theodore Logan, L. Dade Lunsford

Research output: Contribution to journalArticle

165 Citations (Scopus)

Abstract

BACKGROUND. The authors evaluated results after stereotactic radiosurgery (SR) for brain metastases from renal cell carcinoma (RCC) and identified factors associated with improved survival and tumor control. METHODS. The authors reviewed the management results from a total of 52 RCC brain metastases in 35 consecutive patients who underwent stereotactic radiosurgery (SR) during a 9-year interval. Twenty-eight patients also underwent whole brain radiation therapy (WBRT). The mean tumor volume was 2.4 mL (range, 0.1-14.1 mL). The mean dose delivered to the tumor margin was 17 gray (Gy) (range, 13-20 Gy). Univariate and multivariate testing was performed to determine significant prognostic factors. RESULTS. The median survival was 11 months after SR and 14 months after brain tumor diagnosis. Only 2 patients (8%) died of progression of the irradiated tumor. Age <55 years, lack of active systemic disease, and use of chemotherapy and/or immunotherapy after SR were significant favorable prognostic factors in multivariate testing. Post-SR imaging was evaluated in 26 patients (39 tumors). The local control rate from the 39 treated tumors imaged was 90% (tumor disappearance, 21%; tumor regression, 44%; and stable disease, 26%). Local recurrence developed in 3 patients (4 lesions) and remote brain disease in 12 patients. No patient developed a new focal neurologic deficit due to SR. Patients were classified into two groups: SR with and SR without WBRT. The addition of WBRT to SB did not improve survival. Distant failure occurred similarly in both groups (46% vs. 50%). WBRT combined with SR may contribute to local control, but did not prevent the development of new remote tumors. CONCLUSIONS. SR for brain metastasis from RCC results in brain disease control in the majority of patients and was associated with few complications. Early detection of brain metastases and treatment with SR provides extended quality survival.

Original languageEnglish (US)
Pages (from-to)344-353
Number of pages10
JournalCancer
Volume83
Issue number2
DOIs
StatePublished - Jul 15 1998
Externally publishedYes

Fingerprint

Radiosurgery
Renal Cell Carcinoma
Neoplasm Metastasis
Brain
Neoplasms
Radiotherapy
Survival
Brain Diseases
Neurologic Manifestations
Tumor Burden
Brain Neoplasms
Immunotherapy
Recurrence
Drug Therapy

Keywords

  • Brain metastasis
  • Radiation therapy
  • Radiosurgery
  • Renal cell carcinoma
  • Stereotactic surgery

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Stereotactic radiosurgery for brain metastasis from renal cell carcinoma. / Mori, Yoshimasa; Kondziolka, Douglas; Flickinger, John C.; Logan, Theodore; Lunsford, L. Dade.

In: Cancer, Vol. 83, No. 2, 15.07.1998, p. 344-353.

Research output: Contribution to journalArticle

Mori, Yoshimasa ; Kondziolka, Douglas ; Flickinger, John C. ; Logan, Theodore ; Lunsford, L. Dade. / Stereotactic radiosurgery for brain metastasis from renal cell carcinoma. In: Cancer. 1998 ; Vol. 83, No. 2. pp. 344-353.
@article{fc780b40461c4edca8dc33428c7d4c82,
title = "Stereotactic radiosurgery for brain metastasis from renal cell carcinoma",
abstract = "BACKGROUND. The authors evaluated results after stereotactic radiosurgery (SR) for brain metastases from renal cell carcinoma (RCC) and identified factors associated with improved survival and tumor control. METHODS. The authors reviewed the management results from a total of 52 RCC brain metastases in 35 consecutive patients who underwent stereotactic radiosurgery (SR) during a 9-year interval. Twenty-eight patients also underwent whole brain radiation therapy (WBRT). The mean tumor volume was 2.4 mL (range, 0.1-14.1 mL). The mean dose delivered to the tumor margin was 17 gray (Gy) (range, 13-20 Gy). Univariate and multivariate testing was performed to determine significant prognostic factors. RESULTS. The median survival was 11 months after SR and 14 months after brain tumor diagnosis. Only 2 patients (8{\%}) died of progression of the irradiated tumor. Age <55 years, lack of active systemic disease, and use of chemotherapy and/or immunotherapy after SR were significant favorable prognostic factors in multivariate testing. Post-SR imaging was evaluated in 26 patients (39 tumors). The local control rate from the 39 treated tumors imaged was 90{\%} (tumor disappearance, 21{\%}; tumor regression, 44{\%}; and stable disease, 26{\%}). Local recurrence developed in 3 patients (4 lesions) and remote brain disease in 12 patients. No patient developed a new focal neurologic deficit due to SR. Patients were classified into two groups: SR with and SR without WBRT. The addition of WBRT to SB did not improve survival. Distant failure occurred similarly in both groups (46{\%} vs. 50{\%}). WBRT combined with SR may contribute to local control, but did not prevent the development of new remote tumors. CONCLUSIONS. SR for brain metastasis from RCC results in brain disease control in the majority of patients and was associated with few complications. Early detection of brain metastases and treatment with SR provides extended quality survival.",
keywords = "Brain metastasis, Radiation therapy, Radiosurgery, Renal cell carcinoma, Stereotactic surgery",
author = "Yoshimasa Mori and Douglas Kondziolka and Flickinger, {John C.} and Theodore Logan and Lunsford, {L. Dade}",
year = "1998",
month = "7",
day = "15",
doi = "10.1002/(SICI)1097-0142(19980715)83:2<344::AID-CNCR19>3.0.CO;2-T",
language = "English (US)",
volume = "83",
pages = "344--353",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "2",

}

TY - JOUR

T1 - Stereotactic radiosurgery for brain metastasis from renal cell carcinoma

AU - Mori, Yoshimasa

AU - Kondziolka, Douglas

AU - Flickinger, John C.

AU - Logan, Theodore

AU - Lunsford, L. Dade

PY - 1998/7/15

Y1 - 1998/7/15

N2 - BACKGROUND. The authors evaluated results after stereotactic radiosurgery (SR) for brain metastases from renal cell carcinoma (RCC) and identified factors associated with improved survival and tumor control. METHODS. The authors reviewed the management results from a total of 52 RCC brain metastases in 35 consecutive patients who underwent stereotactic radiosurgery (SR) during a 9-year interval. Twenty-eight patients also underwent whole brain radiation therapy (WBRT). The mean tumor volume was 2.4 mL (range, 0.1-14.1 mL). The mean dose delivered to the tumor margin was 17 gray (Gy) (range, 13-20 Gy). Univariate and multivariate testing was performed to determine significant prognostic factors. RESULTS. The median survival was 11 months after SR and 14 months after brain tumor diagnosis. Only 2 patients (8%) died of progression of the irradiated tumor. Age <55 years, lack of active systemic disease, and use of chemotherapy and/or immunotherapy after SR were significant favorable prognostic factors in multivariate testing. Post-SR imaging was evaluated in 26 patients (39 tumors). The local control rate from the 39 treated tumors imaged was 90% (tumor disappearance, 21%; tumor regression, 44%; and stable disease, 26%). Local recurrence developed in 3 patients (4 lesions) and remote brain disease in 12 patients. No patient developed a new focal neurologic deficit due to SR. Patients were classified into two groups: SR with and SR without WBRT. The addition of WBRT to SB did not improve survival. Distant failure occurred similarly in both groups (46% vs. 50%). WBRT combined with SR may contribute to local control, but did not prevent the development of new remote tumors. CONCLUSIONS. SR for brain metastasis from RCC results in brain disease control in the majority of patients and was associated with few complications. Early detection of brain metastases and treatment with SR provides extended quality survival.

AB - BACKGROUND. The authors evaluated results after stereotactic radiosurgery (SR) for brain metastases from renal cell carcinoma (RCC) and identified factors associated with improved survival and tumor control. METHODS. The authors reviewed the management results from a total of 52 RCC brain metastases in 35 consecutive patients who underwent stereotactic radiosurgery (SR) during a 9-year interval. Twenty-eight patients also underwent whole brain radiation therapy (WBRT). The mean tumor volume was 2.4 mL (range, 0.1-14.1 mL). The mean dose delivered to the tumor margin was 17 gray (Gy) (range, 13-20 Gy). Univariate and multivariate testing was performed to determine significant prognostic factors. RESULTS. The median survival was 11 months after SR and 14 months after brain tumor diagnosis. Only 2 patients (8%) died of progression of the irradiated tumor. Age <55 years, lack of active systemic disease, and use of chemotherapy and/or immunotherapy after SR were significant favorable prognostic factors in multivariate testing. Post-SR imaging was evaluated in 26 patients (39 tumors). The local control rate from the 39 treated tumors imaged was 90% (tumor disappearance, 21%; tumor regression, 44%; and stable disease, 26%). Local recurrence developed in 3 patients (4 lesions) and remote brain disease in 12 patients. No patient developed a new focal neurologic deficit due to SR. Patients were classified into two groups: SR with and SR without WBRT. The addition of WBRT to SB did not improve survival. Distant failure occurred similarly in both groups (46% vs. 50%). WBRT combined with SR may contribute to local control, but did not prevent the development of new remote tumors. CONCLUSIONS. SR for brain metastasis from RCC results in brain disease control in the majority of patients and was associated with few complications. Early detection of brain metastases and treatment with SR provides extended quality survival.

KW - Brain metastasis

KW - Radiation therapy

KW - Radiosurgery

KW - Renal cell carcinoma

KW - Stereotactic surgery

UR - http://www.scopus.com/inward/record.url?scp=0032527956&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032527956&partnerID=8YFLogxK

U2 - 10.1002/(SICI)1097-0142(19980715)83:2<344::AID-CNCR19>3.0.CO;2-T

DO - 10.1002/(SICI)1097-0142(19980715)83:2<344::AID-CNCR19>3.0.CO;2-T

M3 - Article

VL - 83

SP - 344

EP - 353

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 2

ER -