Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2012;8(1):22-26.
Published online June 30, 2012.
Gamma Knife Radiosurgery for Metastatic Tumors in Cerebellum
Sang-Deok Kim, In-Young Kim, Tae-Young Jung, Shin Jung, Woo-Youl Jang
Brain Tumor Clinic & Gamma Knife Center, Department of Neurosurgery, Chonnam National University Hwasun Hospital, Hwasun, Korea
The local control of Gamma Knife radiosurgery (GKR) for metastatic brain tumors and overall survival of these patients are known to be generally favorable. However, actually, the tumor control may be different according to the sites of the brain. We investigated the outcome of GKR in the patients with cerebellar metastasis. Materials and Methods: We investigated the outcome of GKR for cerebellar metastases. Between July 2004 and September 2010, total 163 patients underwent GKR for metastatic brain tumor (s) in cerebellum and were followed up. The mean age was 63.7 years (range, 37 to 86), and their Karnofsky performance score (KPS) were all not less than 70. The number of male patients was 89 and female 74. The primary cancers of the patients were non-small cell lung cancer (n=92), small cell lung cancer (n=27), breast cancer (n=24), and others (n=20). The total number of treated cerebellar metastases with GKR was 266. The locations of the tumors were cerebellar hemisphere (n=221), and vermis (n=45). At GKR, the mean tumor volume was 1.15cc (range, 0.003 to 32.9) and the mean prescription dose was 22Gy (range, 10 to 25) to the tumor margin.
We investigated the local tumor control and overall survival of the patients. The clinical and imaging follow-up was done in 136 patients. The tumor control rate was 83% (183 out of 220 tumors) tumors, and the median progression-free survival was 6.2 months (range, 1 to 54). The significant favorable prognostic factors related to the tumor control were tumor volume less than 5cc (p=0.002) and prescription radiation dose more than 18Gy (p=0.009). The overall median survival after the GKR was 8.2 months (range, 1 to 65), and twenty patients (14.7%) are still alive. Other organ metastasis was the only significant prognostic factor (p=0.002) related to the patients’ survival in this investigation.
GKR could be the one of the best management options even for the metastatic tumors in cerebellum.
Key Words: Cerebellar metastasis, Gamma knife radiosurgery, Metastatic brain tumors, Stereotactic radiosurgery.

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