Gamma knife radiosurgery for brainstem metastases

Keywords: brain stem, gamma knife, brain metastasis, radiosurgery, outcome

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     Brainstem tumors can be challenging cancer problems.
Our purpose was to assess the imaging and clinical outcomes of patients with brainstem metastases treated with Leksell Gamma Knife radiosurgery.
     The median age was 61 years (range, 45-83), the median treated lesion volume was 0.78 ml (range, 0.03-5.6 ml), and the median GKRS margin dose was 16 Gy (range, 12-20 Gy).
     28 consecutive patients with brainstem metastases (32 lesions: 8 midbrain, 21 pontine, and 3 medullary) were treated with Gamma Knife radiosurgery (GKRS). Primary diagnoses included 22 cases of lung cancer , 5 breast cancer, 1 rectal cancer.  Overall survival were calculated using the Kaplan-Meier method.
     The median survival time was 9 months after GKRS (range, 2-32). The survival rate was 39.3% at one year and 10.7% at two years. The tumor control rate in the series was 96.9% (n = 31/32). Development of peritumor edema occurred in one patient after GKRS, and four months after GKRS, the edema disappeared.
     This was a retrospective series.
     GKRS with a median margin dose of 16 Gy is a safe and effective local therapy for patients with brainstem metastases.
     Brain stem location is acceptable for radiosurgery using gamma knife technique.


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