Stereotactic radiosurgery for brain metastasis from gynecological malignancies

Kasper,Ekkehard; Ippen,Franziska; Wong,Eric; Uhlmann,Eric; Floyd,Scott; Mahadevan,Anand

doi:10.3892/ol.2017.5621

Stereotactic radiosurgery for brain metastasis from gynecological malignancies

Authors:
- Ekkehard Kasper
- Franziska Ippen
- Eric Wong
- Eric Uhlmann
- Scott Floyd
- Anand Mahadevan
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Affiliations: Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA, Department of Neuro‑oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA, Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
Published online on: January 18, 2017 https://doi.org/10.3892/ol.2017.5621
Pages: 1525-1528
Copyright: © Kasper et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Brain metastases are relatively uncommon in gynecological malignancies, and there is limited available data on their management. The present study reports the outcomes of patients with brain metastasis from gynecological malignancies who were treated with stereotactic radiosurgery (SRS). Patients with brain metastasis from a gynecological primary site were treated with SRS using the Cyberknife™ frameless SRS system. Primary lesions were treated with a single fraction of 16‑22 Gy. A total of 3 resection cavities were treated with 8 Gy 3 times, meaning a total of 24 Gy, and 1 recurrent lesion was re‑irradiated with 5 Gy 5 times, meaning a total of 25 Gy. All patients were followed up with regular magnetic resonance imaging and clinical examinations 1 month after treatment and every 2 months thereafter. A total of 20 lesions in 8 patients were included in this study; 1 patient presented with metastatic endometrial cancer and the remaining 7 presented with metastatic ovarian cancer. The median age was 61 years (range, 48‑78 years). All patients had received systemic therapy prior to developing brain metastasis. A total of 3 patients underwent surgical resection and 1 patient was administered re‑irradiation for recurrence. There were 3 local failures in 2 patients. The actuarial 1‑, 2‑ and 3‑year local control rates were 91, 91 and 76%, respectively. The median overall survival time was 29 months. No SRS‑associated toxicities or neurological mortalities were observed. In conclusion, brain metastasis from gynecological malignancies is uncommon, however, SRS is a safe and effective treatment modality for local control as a primary or adjuvant treatment in patients with this disease.

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