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신장암 뇌전이에 대한 감마나이프방사선수술의 치료 결과

Other Titles
 The Results of Gamma Knife Radiosurgery for Brain Metastases from Renal Cell Carcinoma 
Authors
 김태엽  ;  정현호  ;  강정한  ;  장종희  ;  장진우  ;  박용구  ;  정상섭 
Citation
 Journal of the Korean Society of Stereotactic and Functional Neurosurgery (대한정위기능신경외과학회지), Vol.2(2) : 173-179, 2006 
Journal Title
 Journal of the Korean Society of Stereotactic and Functional Neurosurgery (대한정위기능신경외과학회지) 
ISSN
 1738-6217 
Issue Date
2006
Keywords
Brain metastasis ; Gamma Knife radiosurgery ; Radioresistancy ; Renal cell carcinoma
Abstract
Objective: Renal cell carcinoma (RCC) is a rare tumor which tends to metastasize to the brain in about 4-11% of patients. Metastases from RCC raise specific therapeutic problems because they are relatively unresponsive to whole brain radiation therapy and tend to bleed. The aim of this study was to analyze the therapeutic effects after Gamma Knife radiosurgery (GKS) as a primary treatment for patients harboring brain metastases of RCC. Methods: Between May 1992 and September 2005, 26 patients with 102 brain metastases from RCC underwent 31 GKS procedures. Overall median survival, main cause of death, local control rate, and morbidity related to GKS were evaluated. Age, sex, performance status, number of metastases, volume of metastases, presenting symptom, prior history of craniotomy, prior history of fractionated radiation therapy, prior history of chemotherapy or immunotherapy, maximal dose, tumor marginal dose, number of treatment isocenters, recursive partitioning analysis (RPA) class, and latency period from diagnosis of RCC to that of brain metastases were statistically analyzed to identify significant factors related to prolonged survival. Results: The mean tumor volume was 3.3 (0.02-35.1)cc. Mean maximal and tumor margin dose were 28.0 (15-43)Gy and 17.7 (9-26.6)Gy, respectively. The period of median survival was 10.5 months after GKS and RPA class was only significant factor related to survival. Local tumor control rate was 92.0% and tumor volume was related to local control. Radiation-related edema occurred in 8.9% of cases. Additional whole brain radiation therapy could not affect survival time, local tumor control, but could increase the risk of radiation-related complication. Local and distant tumor recurrences were treated by additional GKS. There was no permanent morbidity after GKS. Conclusion: Despite of the radioresistant nature of RCC, GKS alone could effectively control brain metastases from RCC not only as a primary treatment, but also as a secondary salvage for recurrence. Early detection of brain metastases, aggressive treatment of systemic disease, and a therapeutic strategy including repeated radiosurgery without a combination of whole brain radiation therapy can offer patients an extended survival.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Jeong Han(강정한)
Kim, Tae Yup(김태엽)
Park, Yong Gou(박용구)
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
Jung, Hyun Ho(정현호)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/175690
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