Gamma Knife Radiosurgery for Metastatic Melanoma: An Analysis of Survival, Outcome, and Complications

作者：Sean D. Lavine, Zbigniew P. Petrovich, Aaron Cohen‐Gadol, Lena S. Masri, Donald L. Morton, Steven J O'Day, Richard Essner, Vladimir Zelman, Cheng‐Ping Yu, Gary Luxton, Michael L.J. Apuzzo · 发表于：Neurosurgery · 年份：1999 · DOI：10.1097/00006123-199901000-00031 · 被引用次数：132 · 研究领域：Brain Metastases and Treatment、Cutaneous Melanoma Detection and Management、Glioma Diagnosis and Treatment

OBJECTIVE: Although the mainstays for treatment of metastatic brain disease have been surgery and/or external beam radiation therapy, an increasing number of patients are being referred for stereotactic radiosurgery as the primary intervention for their intracranial pathological abnormalities. The lack of efficacy and cognitive and behavioral consequences of whole brain irradiation have prompted clinicians to select patients for alternative therapies. This study analyzes the effectiveness of Leksell gamma unit therapy for metastatic melanoma to the brain. METHODS: We present our experience with 59 Leksell gamma unit treatment sessions in 45 consecutive patients who presented with metastatic melanoma to the brain. Five of these procedures were performed as salvage therapy for patients who needed second radiosurgical treatment for new lesions that were remote from the previous targets and were not included in the overall analyses. RESULTS: The population included 78% male patients. The mean patient age was 53 years (age range, 24-80 yr). The mean time from diagnosis of primary melanoma to discovery of brain metastasis was 43 months (median, 27.5 mo; range, 1-180 mo). At the time of diagnosis of brain disease, 35.5% of the patients (16 of 45 patients) had neurological symptoms, 77.7% (35 of 45 patients) had known visceral metastases, and 11.1% (5 of 45 patients) had seizure disorders. Eighty-six percent of the lesions (80 of 93 lesions) were cortical, 12% (11 of 93 lesions) were...