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Stereotactic radiosurgical treatment of parenchymal brain metastases from prostate adenocarcinoma.

Authors
Kim, SH; Chao, ST; Toms, SA; Vogelbaum, MA; Barnett, GH; Suh, JH; Weil, RJ
Citation
Surgical neurology, 69(6):641-646, 2008
Journal Title
Surgical neurology
ISSN
0090-30191879-3339
Abstract
BACKGROUND: Prostate cancer metastatic to the brain is uncommon and has been associated historically with a poor prognosis. It has been suggested that SRS may be an effective treatment. METHODS: We analyzed a prospective, institutional review board-approved database of patients treated with SRS and identified 5 patients with prostate cancer metastasis. Clinical, pathologic, radiographic, treatment, and outcome information regarding the primary/systemic disease status, and brain metastases were collected. RESULTS: Mean age at the time of treatment for CNS parenchymal metastasis was 72.0 +/- 8.3 years and lesions developed 82.0 +/- 65.1 months after the initial tumor was identified. Four patients had a single lesion and 1 had 4; 3 patients were treated with SRS alone, 1 with WBRT and SRS, and 1 with surgery, then WBRT and SRS. All were symptomatic. Stereotactic radiosurgery controlled the brain metastases in all 5 patients, with functional improvement and with a typical increase of 1 grade in the Karnofsky performance score. Mean survival was at least 10.0 +/- 6.7 months (range, 6-22+ months). Two patients died of conditions unrelated to prostate cancer and 2 of systemic disease progression; 1is alive and asymptomatic. There were no local SRS failures and no new CNS lesions. CONCLUSIONS: Stereotactic radiosurgery for prostate cancer metastatic to the brain, alone or in combination with brain radiation therapy and surgery, is a safe, effective treatment that improves neurologic symptoms and function and may prolong survival.
MeSH terms
Adenocarcinoma/mortalityAdenocarcinoma/secondary*Adenocarcinoma/surgery*AgedBrain Neoplasms/mortalityBrain Neoplasms/secondary*Brain Neoplasms/surgery*Cohort StudiesHumansMaleMiddle AgedProstatic Neoplasms/mortalityProstatic Neoplasms/pathology*Radiosurgery*Retrospective StudiesSurvival RateTreatment Outcome
DOI
10.1016/j.surneu.2007.05.035
PMID
18262258
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Neurosurgery
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김세혁
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