Gamma Knife radiosurgery combined with stereotactic aspiration as an effective treatment method for large cystic brain metastases

Wang,Hongwei; Qi,Songtao; Dou,Changwu; Ju,Haitao; He,Zhanbiao; Ma,Qinghai

doi:10.3892/ol.2016.4603

Gamma Knife radiosurgery combined with stereotactic aspiration as an effective treatment method for large cystic brain metastases

Authors:
- Hongwei Wang
- Songtao Qi
- Changwu Dou
- Haitao Ju
- Zhanbiao He
- Qinghai Ma
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Affiliations: Department of Neurosurgery, Nanfang Hospital Southern Medical University, Guangzhou, Guangdong 510515, P.R. China, Department of Neurosurgery, Affiliated Hospital of Inner Mongolia Medical College, Hohhot, Inner Mongolia 010050, P.R. China
Published online on: May 18, 2016 https://doi.org/10.3892/ol.2016.4603
Pages: 343-347

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Abstract

In the present study, the efficacy and clinical outcomes of stereotactic aspiration combined with the Gamma Knife radiosurgery (GKRS) method were evaluated retrospectively for patients with large cystic brain metastases. This combined method aims to decrease the tumor weight (volume) and increase the possible radiation dose. The present study involved 48 patients who were diagnosed with cystic metastatic brain tumors between January 2008 and December 2012 in the Department of Neurosurgery of Nanfang Hospital Southern Medical University (Guangzhou, China). Every patient underwent Leksell stereotactic frame, 1.5T magnetic resonance imaging (MRI)‑guided stereotactic cyst aspiration and Leksell GKRS. Subsequent to the therapy, MRI was performed every 3 months. The results indicated that 48 cases were followed up for 24‑72 months, with a mean follow‑up duration of 36.2 months. Following treatment, 44 patients (91.7%) exhibited tumor control and 4 patients (8.3%) experienced progression of the local tumor. During this period, 35 patients (72.9%) succumbed, but only 2 (4.2%) of these succumbed to the brain metastases. The total local control rate was 91.7% and the median overall survival time of all patients was 19.5 months. The 1‑year overall survival rate was 70.8% and the 2‑year overall survival rate was 26.2%. In conclusion, these results indicated that the method of stereotactic cyst aspiration combined with GKRS was safe and effective for patients with large cystic brain metastases. This method is effective for patients whose condition is too weak for general anesthesia and in whom the tumors are positioned at eloquent areas. This method enables patients to avoid a craniotomy, and provides a good tumor control rate, survival time and quality of life.

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