Radiosurgery in Patients with “Radioresistant” Brain Metastases: Outcomes and Prognosis

Abstract

was 90. The median tumor volume treated was 1.0 cm 3 (range, 0.03 - 14.2 cm 3 ). The distribution of DS-GPA scores was 0.5 (n = 7), 1.0 (n = 21), 1.5 (n = 19), 2.0 (n = 22). Baseline DS-GPA recorded was based on presentation at the time of brain metastasis diagnosis.All patientswere followed until death or for at least 12 months.Between the melanomaand RCC groups, therewere no statistically significant differences in gender, ethnicity, age, liver mets, bone mets, primary controlled disease, extracranial disease, baseline KPS, total tumor volume, and largest site of treated volume. Results:Themedianoverallsurvival,mediandistantbraincontrol,andoneyearlocalcontrolwere11.41months,5.3months,and 84.8%,respectively. Forthese parameters,no statisticallysignificantdifferencewas found for the melanomaand RCC subgroups. DS-GPA proved to be a clear indicator of overall survival. Median survival was 3.95 months for patients with 0.5 points, 7.53 months for 1.0 points, 10.49 months for 1.5 points, and the median was not reached for 2.0 points ( p= 0.0011). One year survival rates after radiosurgery were 14.3% for 0.5 points, 35.9% for 1.0 points, 47.4% for 1.5 points, and 68.2% for 2.0 points. DS-GPA did not predict control for local brain tumor ( p= 0.5439) or control of distant brain metastasis ( p= 0.3124).