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

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dc.contributor.authorRoh, TH-
dc.contributor.authorChoi, MS-
dc.contributor.authorYou, N-
dc.contributor.authorJeong, D-
dc.contributor.authorJang, AH-
dc.contributor.authorSeo, MR-
dc.contributor.authorLee, SR-
dc.contributor.authorKim, SH-
dc.date.accessioned2019-11-13T04:27:05Z-
dc.date.available2019-11-13T04:27:05Z-
dc.date.issued2018-
dc.identifier.issn0167-594X-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/17525-
dc.description.abstractWe 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.-
dc.language.isoen-
dc.subject.MESHAge Factors-
dc.subject.MESHAged-
dc.subject.MESHAged, 80 and over-
dc.subject.MESHBrain Neoplasms/genetics-
dc.subject.MESHBrain Neoplasms/mortality-
dc.subject.MESHBrain Neoplasms/radiotherapy-
dc.subject.MESHBrain Neoplasms/secondary-
dc.subject.MESHErbB Receptors/genetics-
dc.subject.MESHFemale-
dc.subject.MESHFollow-Up Studies-
dc.subject.MESHHumans-
dc.subject.MESHMale-
dc.subject.MESHMutation-
dc.subject.MESHNeoplasm Recurrence, Local-
dc.subject.MESHPatient Selection-
dc.subject.MESHRadiosurgery/adverse effects-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHSurvival Analysis-
dc.subject.MESHTreatment Outcome-
dc.subject.MESHTumor Burden-
dc.titleIdentifying candidates for gamma knife radiosurgery among elderly patients with brain metastases-
dc.typeArticle-
dc.identifier.pmid29327172-
dc.subject.keywordAge-
dc.subject.keywordMetastasis-
dc.subject.keywordRadiosurgery-
dc.subject.keywordSurvival-
dc.contributor.affiliatedAuthor노, 태훈-
dc.contributor.affiliatedAuthor유, 남규-
dc.contributor.affiliatedAuthor정, 동환-
dc.contributor.affiliatedAuthor김, 세혁-
dc.type.localJournal Papers-
dc.identifier.doi10.1007/s11060-018-2745-4-
dc.citation.titleJournal of neuro-oncology-
dc.citation.volume137-
dc.citation.number3-
dc.citation.date2018-
dc.citation.startPage559-
dc.citation.endPage565-
dc.identifier.bibliographicCitationJournal of neuro-oncology, 137(3). : 559-565, 2018-
dc.embargo.liftdate9999-12-31-
dc.embargo.terms9999-12-31-
dc.identifier.eissn1573-7373-
dc.relation.journalidJ00167594X-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Neurosurgery
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