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Radiosurgery to palliate symptoms in brain metastases from uterine cervix cancer

  • Experimental research - Brain Tumors
  • Published:
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Abstract

Background

The optimal management of brain metastases from uterine cervix cancer (UCC) is not well defined because of the rarity of the condition and the scarcity of published reports. Here we report our experience with stereotactic radiosurgery for the management of brain metastases from UCC.

Methods

Thirteen consecutive patients with brain metastases from UCC were managed with a Leksell gamma-knife at our institution between January 2003 and December 2010. Clinical features and radiosurgical outcomes of patients were analyzed retrospectively.

Results

Gamma-knife radiosurgery (GKRS) was chosen as the only treatment in four patients and performed in combination with whole-brain radiotherapy (WBRT) in nine patients. GKRS was conducted simultaneously with WBRT within a 1-month interval in six patients and was chosen as the salvage treatment after WBRT in three patients. The mean number of metastatic brain lesions per patient was 5.7 (range, 1–16). The median cumulative tumor volume was 23.7 cm3 (range, 2.7–40.2 cm3), and the median marginal dose covering the tumors was 14 Gy of a 50 % isodose line (range, 8–25 Gy). Nine patients showed relief of main neurologic symptoms after GKRS. The median length of time that the patients spent in an improved neurologic state was 11.1 weeks (range, 2–39.6 weeks). The local and distant control rates were 66.7 % and 77.8 %, respectively. The median survival from the date of GKRS until death was 4.6 months (range, 1.0–15.9 months). The 6-month and 12-month survival rates after GKRS were 38 and 15 %, respectively.

Conclusions

GKRS could be an efficient palliative measure to relieve neurologic symptoms caused by brain metastasis from UCC.

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Conflicts of interest

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Author information

Author notes

  1. Sang-Bong Chung

    Present address: Department of Neurosurgery, National Medical Center, 245 Eulgi-ro, Jung-gu, Seoul, 100-799, Republic of Korea

Authors and Affiliations

  1. Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea

    Sang-Bong Chung, Kyung-Il Jo, Ho-Jun Seol, Do-Hyun Nam & Jung-Il Lee

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  1. Sang-Bong Chung
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  2. Kyung-Il Jo
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Corresponding author

Correspondence to Sang-Bong Chung.

Additional information

Comment

Cancer patients survive longer with the progress of oncological treatment. As neurosurgeons, we are increasingly confronted with brain metastases deriving from tumors such as ovarian cancer, etc., which did not occur in earlier years. Brain metastases of different tumors seem to occur at different stages of the primary disease and patient treatment for brain metastases may vary accordingly. This is another paper on radiosurgery for rare brain metastases that helps us understand what may be the best approach in the treatment of brain metastases depending on the primary tumor’s histology (J Neurosurg 2005, 102 (Suppl):287–88). In this paper, patients receiving a combination of radiosurgery and whole-brain radiotherapy survived longer than patients receiving radiosurgery alone. This is most likely based on a selection bias as stated by the authors and should not mislead clinicians in their decision-making.

Thomas Mindermann

Zurich, Switzerland

This study was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry for Health & Welfare Affairs, Republic of Korea (A092255).

Permission to perform this study was obtained from the institutional review board at our hospital (IRB file number: 2011-09-008).

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Chung, SB., Jo, KI., Seol, HJ. et al. Radiosurgery to palliate symptoms in brain metastases from uterine cervix cancer. Acta Neurochir 155, 399–405 (2013). https://doi.org/10.1007/s00701-012-1576-x

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  • DOI: https://doi.org/10.1007/s00701-012-1576-x

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