LINAC-based radiosurgery for melanoma, sarcoma and renal cell carcinoma brain metastases

J Neurosurg Sci. 2020 Feb;64(1):37-43. doi: 10.23736/S0390-5616.16.03745-0. Epub 2016 Sep 7.

Abstract

Background: The aim of this study was to report response, overall survival (OS) and toxicity in patients with radioresistant brain metastases (BM) treated with stereotactic radiosurgery (SRS).

Methods: Patients with renal cell carcinoma, melanoma and sarcoma with one to four brain metastases received SRS without whole brain radiotherapy.

Results: Fifty patients with 77 BM were treated. 46 (92%) patients with 71 BM were evaluable. Median follow-up was 67 months and median OS 11.8 months. At the time of analysis all patients had died. Brain control was conditioned by response to SRS (P<0.0001), while OS by histology (renal cell carcinoma versus melanoma and sarcoma) (P=0.04) and status of the tumour outside the brain (P=0.05). Treatment was well tolerated without more than grade 2 acute toxicity.

Conclusions: Treatment of BM from radioresistant tumors with SRS assures good brain control and OS with low toxicity. Our data suggest a better prognosis associated to renal cell carcinoma histology.

MeSH terms

  • Adult
  • Aged
  • Brain Neoplasms / radiotherapy*
  • Brain Neoplasms / secondary*
  • Carcinoma, Renal Cell / radiotherapy
  • Carcinoma, Renal Cell / secondary
  • Female
  • Humans
  • Kidney Neoplasms / pathology
  • Male
  • Melanoma / radiotherapy
  • Melanoma / secondary
  • Middle Aged
  • Radiosurgery / methods*
  • Retrospective Studies
  • Sarcoma / radiotherapy
  • Sarcoma / secondary
  • Treatment Outcome
  • Young Adult