Abstract
Metastases from renal cell carcinoma raise specific therapeutic problems because they are relatively unresponsive to whole brain radiation therapy and tend to bleed. Recently, stereotactically guided high-precision irradiation as a single dose application (radiosurgery) showed promising treatment results for selected patients with brain metastases from renal cell carcinoma. Radiosurgery appears attractive due to its low risk and minimal invasiveness. Multiple lesions can be treated at the same time and retreatments can be performed for local or distant recurrences.
Similar content being viewed by others
References
Alexander E3rd, Moriarty TM, Davis RB et al. (1995) Stereotactic radiosurgery for the definitive, noninvasive treatment of brain metastases. J Natl Cancer Inst 87:34–40
Andrews DW, Scott CB, Sperduto PW, Flanders AE, Gaspar LE, Schell MC, Werner-Wasik M, Demas W, Ryu J, Bahary JP, Souhami L, Rotman M, Mehta MP, Curran WJJr (2004) Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet 363:1665–1672
Auchter RM, Lamond JP, Alexander E et al. (1996) A multiinstitutional outcome and prognostic factor analysis of radiosurgery for resectable single brain metastasis. Int J Radiat Oncol Biol Phys 35: 27–35
Bindal AK, Bindal RK, Hess KR, Shiu A, Hassenbusch SJ, Shi WM, Sawaya R (1996) Surgery versus radiosurgery in the treatment of brain metastasis. J Neurosurg 84:748–754
Bobo RH, Laske DW, Akbasak A, Morrison PF, Dedrick RL, Oldfield EH (1994) Convection-enhanced delivery of macromolecules in the brain. Proc Natl Acad Sci U S A 96:2076–2080
Boogerd W, Dalesio O, Bais EM, Van der Sande JJ (1992) Response of brain metastases from breast cancer to systemic chemotherapy. Cancer 69:972–980
Borgelt B, Gelber R, Kramer S, Brady LW, Chang CH, Davis LW, Perez CA, Hendrickson FR (1980) The palliation of brain metastases: final results of the first two studies by the Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys 6:1–9
Brown PD, Brown CA, Pollock BE, Gorman DA, Foote RL (2002) Stereotactic radiosurgery for patients with “radioresistant” brain metastases. Neurosurgery 51:656–667
Cairncross JG, Kim JH, Posner JB (1980) Radiation therapy for brain metastases. Ann Neurol 7:529–541
Chidel MA, Suh JH, Barnett GH (2000) Brain metastases: presentation, evaluation, and management. Cleve Clin J Med 67:120–127
Cohen N, Strauss G, Lew R, Silver D, Recht L (1998) Should prophylactic anticonvulsants be administered to patients with newly-diagnosed cerebral metastases? A retrospective analysis. J Clin Oncol 6:1621–1624
Colleoni M, Graiff C, Nelli P, Vicario G, Sgarbossa G, Pancheri F, Manente P (1997) Activity of combination chemotherapy in brain metastases from breast and lung adenocarcinoma. Am J Clin Oncol 20:303–307
Culine S, Bekradda M, Kramar A, Rey A, Escudier B, Droz JP. (1998) Prognostic factors for survival in patients with brain metastases from renal cell carcinoma. Cancer 83:2548–2553
Diener-West M, Dobbins TW, Phillips TL, Nelson DF (1989) Identification of an optimal subgroup for treatment evaluation of patients with brain metastases using RTOG study 7916. Int J Radiat Oncol Biol Phys 16:669–673
Elhilali MM, Gleave M, Fradet Y, Davis I, Venner P, Saad F, Klotz L, Moore R, Ernst S, Paton V (2000) Placebo-associated remissions in a multicentre, randomized, double-blind trial of interferon gamma-1b for the treatment of metastatic renal cell carcinoma. The Canadian Urologic Oncology Group. BJU Int 86:613–618
Flickinger JC, Kondziolka D, Lunsford LD, Coffey RJ, Goodman ML, Shaw EG, Hudgins WR, Weiner R, Harsh GR4th, Sneed PK et al. (1994) A multi-institutional experience with stereotactic radiosurgery for solitary brain metastasis. Int J Radiat Oncol Biol Phys 28:797–802
Fuller BG, Kaplan ID, Adler J, Cox RS, Bagshaw MA (1992) Stereotactic radiosurgery for brain metastasis: the importance of adjuvant whole brain irradiation. Int J Radiat Oncol Biol Phys 23:413–418
Gaspar L, Scott C, Rotman M et al. (1997) Recursive partitioning analysis (RPA) of prognostic factors in three radiation therapy oncology group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 37:745–751
Glantz MJ, Cole BF, Forsyth PA, Recht LD, Wen PY, Chamberlain MC, Grossman SA, Cairncross JG (2000) Practice parameter: anticonvulsant prophylaxis in patients with newly diagnosed brain tumors. Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 54:1886–1893
Goyal LK, Suh JH, Reddy CA, Barnett GH (2000) The role of whole brain radiotherapy and stereotactic radiosurgery on brain metastases from renal cell carcinoma. Int J Radiat Oncol Biol Phys 47:1007–1012
Hernandez L, Zamorano L, Sloan A et al. (2002) Gamma knife radiosurgery for renal cell carcinoma brain metastases. J Neurosurg 97 [Suppl 5]:489–493
Hoskin PJ, Crow J, Ford HT (1990) The influence of extent and local management on the outcome of radiotherapy for brain metastases. Int J Radiat Oncol Biol Phys 19:111–115
Kurtz JM, Gelber R, Brady LW, Carella RJ, Cooper JS (1981) The palliation of brain metastases in a favorable patient population: a randomized clinical trial by the Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys 7:891–895
Maor MH, Frias AE, Oswald MJ (1988) Palliative radiotherapy for brain metastases in renal carcinoma. Cancer 62:1912–1917
Mori Y, Kondziolka D, Flickinger JC, Logan T, Lunsford LD (1998) Stereotactic radiosurgery for brain metastasis from renal cell carcinoma. Cancer 83:344–353
Muacevic A, Kreth FW, Horstmann GA et al. (1999) Surgery and radiotherapy compared with gamma knife radiosurgery in the treatment of solitary cerebral metastases of small diameter. J Neurosurg 91:35–43
Muacevic A, Kreth FW, Mack A, Tonn J-C, Wowra B (2004) Stereotactic radiosurgery without radiation therapy providing high local tumor control of multiple brain metastases from renal cell carcinoma. Minim Invasive Neurosurg 47:203–208
Muacevic A, Uhl E, Steiger HJ, Reulen HJ (2000) Accuracy and clinical applicability of a passive marker based frameless neuronavigation system. J Clin Neurosci 7:414–418
Newton HB (1994) Primary brain tumors: review of etiology, diagnosis and treatment. Am Fam Physician 49:787–797
Newton HB, Slivka MA, Volpi C, Bourekas EC, Christoforidis GA, Baujan MA, Slone W, Chakeres DW (2003) Intra-arterial carboplatin and intravenous etoposide for the treatment of metastatic brain tumors. J Neurooncol 61:35–44
Newton HB (2002) Chemotherapy for the treatment of metastatic brain tumors. Expert Rev Anticancer Ther 2:495–506
Patchell RA, Tibbs PA, Walsh JW, Dempsey RJ, Maruyama Y, Kryscio RJ, Markesbery WR, Macdonald JS, Young B (1990) A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 322:494–500
Patchell RA, Tibbs PA, Regine WF et al. (1998) Postoperative radiotherapy in the treatment of single metastases to the brain. JAMA 280:1485–1489
Patchell RA (2003) The management of brain metastases. Cancer Treat Rev 29:533–540
Payne BR, Prasad D, Szeifert G, Steiner M, Steiner L (2000) Gamma surgery for intracranial metastases from renal cell carcinoma. J Neurosurg 92:760–765
Posner JB (1992) Management of brain metastases. Rev Neurol (Paris) 148:477–487
Sanghavi SN, Miranpuri SS, Chappell R, Buatti JM, Sneed PK, Suh JH, Regine WF, Weltman E, King VJ, Goetsch SJ, Breneman JC, Sperduto PW, Scott C, Mabanta S, Mehta MP (2001) Radiosurgery for patients with brain metastases: a multi-institutional analysis, stratified by the RTOG recursive partitioning analysis method. Int J Radiat Oncol Biol Phys 51:426-434
Schoggl A, Kitz K, Ertl A et al. (1998) Gamma-knife radiosurgery for brain metastases of renal cell carcinoma: results in 23 patients. Acta Neurochir 140:549–555
Shaw E, Scott C, Souhami L, Dinapoli R, Kline R, Loeffler J, Farnan N (2000) Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: final report of RTOG protocol 90-05. Int J Radiat Oncol Biol Phys 47:291–298
Sheehan JP, Sun MH, Kondziolka D, Flickinger J, Lunsford LD (2003) Radiosurgery in patients with renal cell carcinoma metastasis to the brain: long-term outcomes and prognostic factors influencing survival and local tumor control. J Neurosurg 98:342–349
Soffietti R, Ruda R, Mutani R (2002) Management of brain metastases. J Neurol 249:1357–1369
Sturm V, Kober B, Hoever KH et al. (1987) Stereotactic percutaneous single dose irradiation of brain metastasis with a linear accelerator Int J Radiat Oncol Biol Phys 13:279–282
Weltman E, Salvajoli JV, Brandt RA et al. (2000) Radiosurgery for brain metastases: a score index for predicting prognosis. Int J Radiat Oncol Biol Phys 15:1155–1161
West J, Maor M (1980) Intracranial metastases: behavioral patterns related to primary site and results of treatment by whole brain irradiation. Int J Radiat Oncol Biol Phys 6:11–15
Wowra B, Siebels M, Muacevic A, Kreth FW, Mack A, Hofstetter Al (2002) Repeated gamma knife surgery for multiple brain metastases from renal cell carcinoma. J Neurosurg 97:785–793
Wowra B, Czempiel H, Cibis R, Horstmann GA (1997) Profil der ambulanten Radiochirurgie mit dem Gamma-Knife-System. Teil 1: Methode und multizentrisches Behandlungskonzept. Radiologe 37:995–1002
Wronski M, Maor MH, Davis BJ, Davis BJ, Sawaya R, Levin VA (1997) External radiation of brain metastases from renal carcinoma: a retrospective study of 119 patients from the M.D. Anderson Cancer Center. Int J Radiat Oncol Biol Phys 37:753–759
Wronski M, Arbit E, Russo P, Galicich JH (1996) Surgical resection of brain metastases from renal cell carcinoma in 50 patients. Urology 47:187–93
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Muacevic, A., Siebels, M., Tonn, JC. et al. Treatment of brain metastases in renal cell carcinoma: radiotherapy, radiosurgery, or surgery?. World J Urol 23, 180–184 (2005). https://doi.org/10.1007/s00345-004-0471-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00345-004-0471-3