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Identifying candidates for gamma knife radiosurgery among elderly patients with brain metastases

Authors
Roh, TH  | Choi, MS | You, N  | Jeong, D  | Jang, AH | Seo, MR | Lee, SR | Kim, SH
Citation
Journal of neuro-oncology, 137(3). : 559-565, 2018
Journal Title
Journal of neuro-oncology
ISSN
0167-594X1573-7373
Abstract
We investigated the outcomes of gamma knife radiosurgery (GKRS) for elderly patients (>/= 65 years) with brain metastases, and identified survival-associated factors. We retrospectively analyzed data from 115 patients treated with GKRS for 1-15 brain metastases. The median patient age was 72 years: most primary tumors were pulmonary (n = 83). The mean lesion volume was 2.1 +/- 4.8 mL. A mean dose of 19.3 Gy was delivered to the mean 63.9% isodose line. The median overall survival (OS) was 5.3 months (95% confidence interval [CI] 3.5-7.1). During follow-up (median, 5.1 months), 91 patients died of primary cancer progression while 1 died of unknown causes. The 6- and 12-month local control rates were 94.9 and 88.1%, respectively. On multivariate analysis, female sex (p = 0.005, hazard ratio [HR] 0.533, 95% CI 0.343-0.827) and a controlled primary tumor (p < 0.001, HR 0.328, 95% CI 0.180-0.596) were significantly favorable prognostic factors. Of non-small cell lung cancer patients with EGFR mutations, 76.5% were women (p = 0.005). The median OS of EGFR-mutant and EGFR-wildtype patients were 19.1 and 4.7 months, respectively (p = 0.080). Brain metastases < 3 mL showed better local control rates after GKRS (p = 0.005). GKRS produces favorable outcomes in women with brain metastases who are >/= 65 years and have controlled primary tumors. Such patients are therefore suitable candidates for GKRS.
Keywords
MeSH

DOI
10.1007/s11060-018-2745-4
PMID
29327172
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Neurosurgery
Ajou Authors
김, 세혁  |  노, 태훈  |  유, 남규  |  정, 동환
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