Skip to main content

Advertisement

Log in

Stereotactic radiosurgical treatment of brain metastasis of primary tumors that rarely metastasize to the central nervous system

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

We evaluated the local control of gamma knife stereotactic radiosurgery (GKSRS) in the treatment of cerebral metastases from primary tumors that rarely metastasize to the central nervous system (CNS). There is little published data on this subject with very few series on specific primary tumors. We present our experience treating these lesions with GKSRS combined with a review of the salient literature. A retrospective study of 36 patients who collectively underwent 44 GKSRS procedures for CNS metastatic disease was undertaken. Our series includes four patients with sarcoma, two with prostate cancer, three with thyroid cancer, five with endometrial cancer, seven with ovarian cancer, two with cervical cancer, six with esophageal cancer, two with bladder cancer, one with liver cancer, one with pancreatic cancer, and three with testicular cancer. With 44 gamma knife sessions treating 74 tumors, 63 tumors showed no radiographic evidence of progression, and 13 tumors demonstrated radiographic progression between one and 12 months after gamma knife treatment. In six patients in the population, further treatment with GKSRS was necessary due to enlargement of untreated lesions or new metastatic disease. GKSRS for uncommon CNS metastases is appears to be efficacious in controlling the treated tumor. The majority of tumors treated in our study did not progress post gamma knife.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. DiLuna MO, King JT, Knisley JP, Chiang VL (2007) Prognostic factors for survival after stereotactic radiosurgery vary with the number of cerebral metastases. Cancer 109:135–145

    Article  PubMed  Google Scholar 

  2. Wen PY, Loeffler JS (2000) Brain metastases. Curr Treat Options Oncol 1:447–458

    Article  PubMed  CAS  Google Scholar 

  3. Barnholtz-Sloan JS, Sloan AE, Davis FG, Vigneau FD, Lai P, Sawaya RE (2004) Incidence proportions of brain metastases in patients diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System. J Clin Oncol 22:2865–2872

    Article  PubMed  Google Scholar 

  4. Delattre JY, Krol G, Thaler HT, Posner JB (1988) Distribution of brain metastases. Arch Neurol 45:741–744

    Article  PubMed  CAS  Google Scholar 

  5. Radbill AE, Fiveash JF, Falkenberg ET et al (2004) Initial treatment of melanoma brain metastases using gamma knife radiosurgery: an evaluation of efficacy and toxicity. Cancer 101:825–833

    Article  PubMed  Google Scholar 

  6. Sperduto PW, Berkey B, Gaspar LE, Mehta M, Curran W (2008) A new prognostic index and comparison to three other indices for patients with brain metastases: an analysis of 1,960 patients in the RTOG database. Int J Radiat Oncol Biol Phys 70:510–514

    Article  PubMed  Google Scholar 

  7. Brown PD, Brown CA, Pollock BE, Gorman DA, Foote RL (2002) Stereotactic radiosurgery for patients with “radioresistant” brain metastases. Neurosurgery 51:656–665

    PubMed  Google Scholar 

  8. Flannery T, Kano H, Niranjan A et al (2010) Gamma knife radiosurgery as a therapeutic strategy for intracranial sarcomatous metastases. Int J Radiat Oncol Biol Phys 76(2):513–519

    Article  PubMed  Google Scholar 

  9. Tremont-Lukats IW, Bobustuc G, Lagos GK, Lolas K, Kyritsis AP, Puduvalli VK (2003) Brain metastasis from prostate carcinoma: The M. D Anderson Cancer Center Experience. Cancer 98:363–368

    Article  PubMed  Google Scholar 

  10. Kim SH, Chao ST, Toms SA et al (2008) Stereotactic radiosurgery treatment of parenchymal brain metastases from prostate adenocarcinoma. Surg Neurol 69:641–646

    Article  PubMed  Google Scholar 

  11. Flannery T, Kano H, Niranjan A, Monaco EA 3rd, Flickinger JC, Kofler J, Lunsford LD, Kondziolka D (2010) Stereotactic radiosurgery as a therapeutic strategy for intracranial metastatic prostate carcinoma. J Neurooncol 96:369–374

    Article  PubMed  Google Scholar 

  12. Kim IY, Kondziolka D, Niranjan A, Flickinger JC, Lunsford LD (2009) Gamma knife radiosurgery for metastatic brain tumors from thyroid cancer. J Neurooncol 93:355–359

    Article  PubMed  Google Scholar 

  13. McWilliams RR, Cancer Giannin, Hay ID, Atkinson JL, Stafford SL, Buckner JC (2003) Management of brain metastases from thyroid carcinoma: a study of 16 pathologically confirmed cases over 25 years. Cancer 98:356–362

    Article  PubMed  Google Scholar 

  14. Bernad DM, Sperduto PW, Souhami L, Jensen AW, Roberge D (2010) Stereotactic radiosurgery in the management of brain metastases from primary thyroid cancers. J Neurooncol 98(2):249–252. Epub 2010 Apr 8

    Google Scholar 

  15. Shiohara S, Ohara M, Itoh K, Shiozawa T, Konish I (2003) Successful treatment with stereotactic radiosurgery for brain metastases of endometrial carcinoma: a case report and review of the literature. Int J Gynecol Cancer 13:71–76

    Article  PubMed  CAS  Google Scholar 

  16. Monaco E, Kondizolka D, Mangia S, Niranjan A, Flickinger JC, Lunsford LD (2008) Management of brain metastases from ovarian and endometrial carcinoma with stereotactic radiosurgery. Cancer 113:2610–2614

    Article  PubMed  Google Scholar 

  17. Brown JV, Goldstein BH, Duma CM, Rettenmaier MA, Micha JP (2005) Gamma knife radiosurgery for treatment of ovarian cancer metastatic to the brain. Gynecol Oncol 97:858–861

    Article  PubMed  Google Scholar 

  18. Lee YK, Park NH, Kim JW, Song YS, Kang SB, Lee HP (2008) Gamma knife radiosurgery as an optimal treatment modality for brain metastases from epithelial ovarian cancer. Gynecol Oncol 108:505–509

    Article  PubMed  Google Scholar 

  19. Mahmoud-Ahmed AS, Suh JH, Barnett GH, Webster KD, Kennedy AW (2001) Tumor distribution and survival in six patients with brain metastases from cervical carcinoma. Gynecol Oncol 81:196–200

    Article  PubMed  CAS  Google Scholar 

  20. Weinberg JS, Suki D, Hanbali F, Cohen ZR, Lenzi R, Sawaya R (2003) Metastasis of esophageal carcinoma to the brain. Cancer 98:1925–1933

    Article  PubMed  Google Scholar 

  21. Limbrick DD, Lusis EA, Chicoine MR et al (2009) Combined surgical resection and stereotactic radiosurgery for treatment of cerebral metastases. Surg Neurol 71:280–289

    Article  PubMed  Google Scholar 

  22. Hasegawa T, Kondziolka D, Flickinger JC, Lunsford LD (2003) Stereotactic radiosurgery for brain metastases from gastrointestinal tract cancer. Surg Neurol 60:506–514

    Article  PubMed  Google Scholar 

  23. Da Silva AN, Nagayama K, Schlesinger DJ, Sheehan JP (2009) Gamma knife surgery for brain metastases from gastrointestinal cancer. J Neurosurg 111:423–430

    Article  PubMed  Google Scholar 

  24. Mahmoud-Ahmed AS, Suh JH, Kupelian PA et al (2002) Brain metastases from bladder carcinoma: presentation, treatment and survival. J Urol 167:2419–2422

    Article  PubMed  Google Scholar 

  25. Choi HJ, Cho BC, Sohn JH et al (2009) Brain metastases from hepatocellular carcinoma: prognostic factors and outcome: brain metastasis from HCC. J Neurooncol 91:307–313

    Article  PubMed  Google Scholar 

  26. Nicolato A, Ria A, Foroni R et al (2005) Gamma knife radiosurgery in brain metastases from testicular tumors. Med Oncol 22:45–56

    Article  PubMed  CAS  Google Scholar 

Download references

Financial disclosure

No author has any financial disclosures relevant to the contents of this manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Joshua Y. Menendez.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 22 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Menendez, J.Y., Bauer, D.F., Shannon, C.N. et al. Stereotactic radiosurgical treatment of brain metastasis of primary tumors that rarely metastasize to the central nervous system. J Neurooncol 109, 513–519 (2012). https://doi.org/10.1007/s11060-012-0916-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-012-0916-2

Keywords

Navigation