LONG-TERM RESULTS OF RADIOSURGERY IN PATIENTS WITH METASTATIC BRAIN LESIONS

Objective. To estimate the overall survival of patients with metastatic brain lesions after stereotactic radiosurgery (SRS) using the Gamma Knife apparatus and to study the effect of various predictors on overall survival (OS).

Materials and methods. The study included 406 patients with metastatic brain lesions who underwent SRS on the “Gamma Knife” apparatus. The OS of patients after SRS was estimated with metastases from various primary sites. The prognostic significance of such factors as age, the number of metastases to the brain, the effect on OS of repeated sessions of SRS in intracranial relapses was studied.

Results. After radiosurgery the median of OS in the total cohort was 12.9 months, 1- and 2-year OS — 52.4 and 29.8% respectively. The median of OS in patients with renal cell carcinoma was 18.4 months, breast cancer — 17 months, pulmonary cancer — 10.4 months, melanoma — 10.1 months, colorectal cancer — 4.7 months. The factors for a good prognosis were age <65 years incl. and a single brain metastasis. There was no statistically significant difference in OS in the groups of patients with 2 to 10 metastases and >10 metastases. Conducting repeated courses of SRS for intracranial relapses had a positive effect on the life expectancy of patients.

Conclusion. The obtained data, as well as further study of predictors affecting OS, will help to optimize the treatment strategy of patients with metastatic brain lesions by expanding the indications for radiosurgery.

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Автор(ы): V. A. Hizemava, P. D. Demeshka, А. A. Nаvаselskaya, А. I. Brynkevich, I. I. Minaila