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  • Title: Radiosurgery for brain metastases from unknown primary cancers.
    Author: Niranjan A, Kano H, Khan A, Kim IY, Kondziolka D, Flickinger JC, Lunsford LD.
    Journal: Int J Radiat Oncol Biol Phys; 2010 Aug 01; 77(5):1457-62. PubMed ID: 20056342.
    Abstract:
    PURPOSE: We evaluated the role of Gamma Knife stereotactic radiosurgery in the multidisciplinary management of brain metastases from an undiagnosed primary cancer. METHODS AND MATERIALS: Twenty-nine patients who had solitary or multiple brain metastases without a detectable primary site underwent stereotactic radiosurgery between January 1990 and March 2007 at the University of Pittsburgh. The median patient age was 61.7 years (range, 37.9-78.7 years). The median target volume was 1.0 cc (range, 0.02-23.6 cc), and the median margin radiosurgical dose was 16 Gy (range, 20-70 Gy). RESULTS: After radiosurgery, the local tumor control rate was 88.5%. Twenty four patients died and 5 patients were living at the time of this analysis. The overall median survival was 12 months. Actuarial survival rates from stereotactic radiosurgery at 1 and 2 years were 57.2% and 36.8%, respectively. Factors associated with poor progression-free survival included large tumor volume (3 cc or more) and brainstem tumor location. CONCLUSIONS: Radiosurgery is an effective and safe minimally invasive option for patients with brain metastases from an unknown primary site.
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