Purpose: To evaluate and compare the survival of patients with brain metastasis (BRM) treated by Whole Brain Irradiation (WB1) using Linear Energy Accelerator (LINAC) and by Stereotactic Radiosurgery (SRS) using Gamma Knife (GKRS). Patients and Methods: This study consists of a series of 67 patients with BRM treated with WB1 between 1998 and 1999 and 53 patients with BRM treated with Gamma Knife Radiosurgery (GKRS) between 2000 and 2001. At LSD Health Sciences Center, Shreveport, LA, USA, the patients with BRM were traditionally treated with WBI using a LINAC In January 2000, Leksell Gamma Knife was installed and patients eligible for SRS (i.e. metastatic lesion volume less than 30 ml and number of lesions less than four) were treated with GKRS. From January 2000 to July 2001, 190 patients were treated by GKRS out of which 53 patients were treated for brain mets. During 1998 to 1999, 621 patients were treated with LINAC, of which 67 patients had WBI for BRM. A retrospective study of the data was performed and the overall survival between these two groups was analyzed. The comparability of these two groups was tested by Chi square and T-test values. Log-rank test was used in the survival comparison. Results: The 1 year survival was 26.3% and 22.6% and corresponding mean survival was 7.8 months and 6.7 months for WBI and GKRS groups respectively. There was no statistically significant difference between these two groups' survival. It was evident from imaging defined lesions, that with GKRS the lesions were reduced, stabilized or disappeared in 89% of cases. Conclusion: Survival of patients with BRM treated with WBI or GKRS was similar in these series. The present study suggests that good tumor response by GKRS does not translate in longer patient survival. Survival, tumor response, late effects of Radiotherapy and effects of multiple treatments will be discussed. Keywords: Whole Brain Irradiation, Stereotactic Radiosurgery, Gamma Knife Radiosurgery, Brain Metastasis.
All Science Journal Classification (ASJC) codes
- Cancer Research