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논문 기본 정보

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학술저널
저자정보
Kim, In-Young (Department of Neurosurgery, Brain Tumor Clinic & Gamma Knife Center, Chonnam National University Hwasun Hospital, Chonnam National University College of Medecine) Jung, Shin (Department of Neurosurgery, Brain Tumor Clinic & Gamma Knife Center, Chonnam National University Hwasun Hospital, Chonnam National University College of Medecine) Jung, Tae-Young (Department of Neurosurgery, Brain Tumor Clinic & Gamma Knife Center, Chonnam National University Hwasun Hospital, Chonnam National University College of Medecine) Moon, Kyung-Sub (Department of Neurosurgery, Brain Tumor Clinic & Gamma Knife Center, Chonnam National University Hwasun Hospital, Chonnam National University College of Medecine) Jang, Woo-Youl (Department of Neurosurgery, Brain Tumor Clinic & Gamma Knife Center, Chonnam National University Hwasun Hospital, Chonnam National University College of Medecine) Park, Jae-Young (Department of Neurosurgery, Brain Tumor Clinic & Gamma Knife Center, Chonnam National University Hwasun Hospital, Chonnam National University College of Medecine) Song, Tae-Wook (Department of Ne) Lim, Sa-Hoe
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제61권 제5호
발행연도
2018.1
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633 - 639 (7page)

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Objective : We investigated the outcomes of repeat stereotactic radiosurgery (SRS) for metastatic brain tumors that locally recurred despite previous SRS, focusing on the tumor control. Methods : A total of 114 patients with 176 locally recurring metastatic brain tumors underwent repeat SRS after previous SRS. The mean age was 59.4 years (range, 33 to 85), and there were 68 male and 46 female patients. The primary cancer types were non-small cell lung cancer (n=67), small cell lung cancer (n=12), gastrointestinal tract cancer (n=15), breast cancer (n=10), and others (n=10). The number of patients with a single recurring metastasis was 95 (79.8%), and another 19 had multiple recurrences. At the time of the repeat SRS, the mean volume of the locally recurring tumors was 5.94 mL (range, 0.42 to 29.94). We prescribed a mean margin dose of 17.04 Gy (range, 12 to 24) to the isodose line at the tumor border primarily using a 50% isodose line. Results : After the repeat SRS, we obtained clinical and magnetic resonance imaging follow-up data for 84 patients (73.7%) with a total of 108 tumors. The tumor control rate was 53.5% (58 of the 108), and the median and mean progression-free survival (PFS) periods were 246 and 383 days, respectively. The prognostic factors that were significantly related to better tumor control were prescription radiation dose of 16 Gy (p=0.000) and tumor volume less than both 4 mL (p=0.001) and 10 mL at the repeat SRS (p=0.008). The overall survival (OS) periods for all 114 patients after repeat SRS varied from 1 to 56 months, and median and mean OS periods were 229 and 404 days after the repeat SRS, respectively. The main cause of death was systemic problems including pulmonary dysfunction (n=58, 51%), and the identified direct or suspected brain-related death rate was around 20%. Conclusion : The tumor control following repeat SRS for locally recurring metastatic brain tumors after a previous SRS is relatively lower than that for primary SRS. However, both low tumor volume and high prescription radiation dose were significantly related to the tumor control following repeat SRS for these tumors after previous SRS, which is a general understanding of primary SRS for metastatic brain tumors.
#Metastasis #Gamma knife radiosurgery #Radiation therapy #Recurrence #Stereotactic radiosurgery

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참고문헌 (14)

참고문헌 신청
Ammirati M / 2010 / The role of retreatment in the management of recurrent/progressive brain metastases: a systematic review and evidence-based clinical practice guideline / J Neurooncol 96:85~96 Crossref Baschnagel AM / 2013 / Tumor volume as a predictor of survival and local control in patients with brain metastases treated with gamma knife surgery / J Neurosurg 119:1139~1144 Crossref Chen JC / 2000 / Radiosurgical salvage therapy for patients presenting with recurrence of metastatic disease to the brain / Neurosurg 46:860~866 google schola Cho KR / 2015 / Outcome of gamma knife radiosurgery for metastatic brain tumors derived from non-small cell lung cancer / J Neurooncol 125:331~338 Crossref Jensen CA / 2011 / Cavity-directed radiosurgery as adjuvant therapy after resection of a brain metastasis / J Neurosurg 114:1585~1591 Crossref

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