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Gamma Knife® Stereotactic Radiosurgery for Intracranial Metastases from Conventionally Radioresistant Primary Cancers: Outcome Analysis of Survival and Control of Brain Disease

Objective: The aim of this study was to analyze our experience with stereotactic radiosurgery in the management of patients with brain metastases from radioresistant primary cancers. Methods: We retrospectively reviewed the clinical record of those patients for the outcome measures. All data were coded and entered into multivariate regression analysis for studying the relationship between survival and other variables. Results: Over a 48-month period, 31 patients received radiosurgery for brain metastases from renal cell carcinoma (n = 7), malignant melanoma (n = 14), or colon carcinoma (n = 10) at our institution. The followup ranged from 1–48 months (mean = 17 months). At the time of last followup, 11 patients (35.5%) were alive and 20 had died. Six deaths (30%) resulted from progressive brain disease while 14 patients died from progressive primary and/or extracranial metastatic disease. Mean survival from radiosurgery was 12 months (95% CI, 7–17) and the median survival was 7 months. The 1 and 2 year actuarial survival rates were 32.5 ± 1% and 12.2 ± 1% respectively. The overall survival was directly related to tumor control time (P <0.001) and inversely to the number of metastases (P = 0.031). Conclusion: Gamma Knife® stereotactic radiosurgery for intracranial metastases from conventionally radioresistant primary cancers is a safe and effective method to provide better local control of the brain disease and improve survival time.