Radiosurgery without whole brain radiotherapy in melanoma brain metastases

• Published in: European journal of cancer (1990) Vol. 34; no. 8; pp. 1187 - 1192
• Main Authors: Grob, J.J., Regis, J., Laurans, R., Delaunay, M., Wolkenstein, P., Paul, K., Souteyrand, P., Koeppel, M.C., Murraciole, X., Perragut, J.C., Bonerandi, J.J.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.07.1998; Elsevier
• Subjects: Biological and medical sciences; brain; fotemustine; gamma knife; Medical sciences; melanoma; metastases; Neurosurgery; palliative therapy; quality of life; radiosurgery; radiotherapy; Skull, brain, vascular surgery; stereotactic surgery; surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; metastases; palliative therapy; fotemustine; gamma knife; radiotherapy; melanoma; radiosurgery; brain; stereotactic surgery; quality of life; surgery; Human; Skin disease; Nervous system diseases; Treatment efficiency; Radiosurgery; Stereotaxia; Palliative treatment; Malignant tumor; Metastasis; Cerebral disorder; Quality of life; Treatment; Surgery; Central nervous system disease; Malignant melanoma; Skin; Brain (vertebrata)
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/S0959-8049(98)00026-4

To evaluate the effectiveness of radiosurgery without whole brain radiotherapy in the palliative treatment of melanoma brain metastases, we retrospectively assessed the results in 35 patients: 4 with a solitary brain metastasis, 13 with a single brain metastasis and metastases elsewhere and 18 with multiple brain metastases. The local control rate was 98.2% (55/56 metastases) at 3 months. Median survival was 22 months in patients with a solitary brain metastasis, 7.5 months in patients with a single brain metastasis and metastases elsewhere, and 4 months in patients with multiple brain metastases. Complications were unusual and surgery was required in 2 of 35 patients. These results show for the first time that melanoma patients with a unique brain metastasis with or without metastases elsewhere clearly benefit from tumour control easily obtained by radiosurgery. Although the comparison of radiosurgery with surgery and/or whole brain radiotherapy cannot be adequately addressed, radiosurgery alone seems to provide similar results with lower morbidity and impact on quality of life.