Radiosurgery alone for 1-3 newly-diagnosed brain metastases from melanoma: impact of dose on treatment outcomes

Anticancer Res. 2014 Sep;34(9):5079-82.

Abstract

Background/aim: To compare different doses of stereotactic radiosurgery (SRS) for 1-3 newly-diagnosed cerebral metastases from melanoma.

Patients and methods: Fifty-four patients were assigned to dose groups of 20 Gy (N=36) and 21-22.5 Gy (N=18). Variables additionally analyzed were age, gender, Karnofsky Performance Score (KPS), lactate dehydrogenase (LDH) before SRS, number of cerebral lesions, extracranial lesions, time from melanoma diagnosis to SRS.

Results: The 12-month local control was 72% after 20 Gy and 100% after 21-22.5 Gy (p=0.020). Freedom from new cerebral metastases (p=0.13) and survival (p=0.13) showed no association with SRS dose. On multivariate analyses, improved local control showed significant associations with SRS doses of 21-22.5 Gy (p=0.007) and normal lactate dehydrogenase levels (p=0.018). Improved survival was associated with normal LDH levels (p=0.006) and KPS 90-100 (p=0.046).

Conclusion: SRS doses of 21-22.5 Gy resulted in better local control than 20 Gy. Freedom from new brain metastases and survival were not significantly different.

Keywords: Melanoma; brain metastases; radiosurgery.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Neoplasms / mortality
  • Brain Neoplasms / pathology
  • Brain Neoplasms / secondary*
  • Brain Neoplasms / surgery*
  • Female
  • Humans
  • Male
  • Melanoma / pathology*
  • Middle Aged
  • Prognosis
  • Radiation Dosage
  • Radiosurgery*
  • Retrospective Studies
  • Treatment Outcome