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Gamma Knife surgery for brainstem metastases.

Yanhe Li¹, Desheng Xu, Zhiyuan Zhang

¹Department of Neurosurgery and Gamma Knife Center, Tianjin Medical University 2nd Hospital, Tianjin, People's Republic of China.

Journal of Neurosurgery

|December 5, 2012

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Leksell Gamma Knife surgery effectively controls brainstem metastases in 90.6% of patients. This treatment offers a median survival of 9 months, demonstrating its safety and efficacy for these challenging tumors.

Area of Science:

Neurosurgery
Radiation Oncology
Oncology

Background:

Brainstem metastases present significant treatment challenges due to the critical structures within the brainstem.
Stereotactic radiosurgery has emerged as a valuable tool for managing intracranial malignancies.
Evaluating outcomes for brainstem metastases treated with Gamma Knife surgery is crucial for optimizing patient care.

Purpose of the Study:

To assess the neuroimaging and clinical outcomes of patients with brainstem metastases treated with Leksell Gamma Knife (Leksell Gamma Knife).
To determine the safety and efficacy of Gamma Knife surgery for brainstem metastases.
To analyze survival rates and tumor control following Gamma Knife surgery.

Main Methods:

A consecutive series of 28 patients with 32 brainstem metastases (midbrain, pontine, medullary) were treated with Gamma Knife surgery (GKS).

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Primary diagnoses included lung, breast, and rectal cancers.

Median patient age was 61 years; median lesion volume was 0.78 cm(3); median GKS margin dose was 16 Gy.

Main Results:

The median survival time post-GKS was 9 months (range 2-32 months).
One-year and two-year survival rates were 39.3% and 10.7%, respectively.
A high tumor control rate of 90.6% (29/32 lesions) was achieved, with only one case of transient peritumoral edema.

Conclusions:

Leksell Gamma Knife surgery, with a median margin dose of 16 Gy, is a safe and effective local therapy for brainstem metastases.
The procedure demonstrates significant efficacy in controlling tumor growth.
Gamma Knife surgery represents a viable treatment option for select patients with brainstem metastases.