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Gamma Knife Surgery for Brain Metastasis from Renal Cell Carcinoma : Relationship Between Radiological Characteristics and Initial Tumor Response

Kim, Jin-Wook    (Departments of Neurosurgery Seoul National University College of Medicine   ); Han, Jung-Ho    (Departments of Neurosurgery Seoul National University College of Medicine   ); Park, Chul-Kee    (Departments of Neurosurgery Seoul National University College of Medicine   ); Chung, Hyun-Tai    (Departments of Neurosurgery Seoul National University College of Medicine   ); Paek, Sun-Ha    (Departments of Neurosurgery Seoul National University College of Medicine   ); Kim, Dong-Gyu    (Departments of Neurosurgery Seoul National University College of Medicine  );
  • 초록

    Objective : The authors have speculated that metastatic brain lesions from renal cell carcinoma (RCC) show diverse radiological patterns and tumor responses after Gamma knife surgery (GKS), and have hypothesized that these can be predicted from tumor radiological characteristics. The goal of the current study was to identify the radiological characteristics of RCC brain metastases and the predictors of initial radiosurgical response after GKS. Methods : A retrospective analysis was performed on 48 lesions in 18 patients with RCC brain metastasis treated by GKS. The radiological characteristics of these lesions in magnetic resonance images (MRI) were classified into 3 categories according to enhancement patterns in T1-weighted images and signal intensity characteristics in T2-weighted images. Responses to GKS were analyzed according to these categories, and in addition, other potential predictive factors were also evaluated. Results : MRI findings in the three categories were diverse, though numbers of the lesion were comparable. At 2-month MRI follow-ups after GKS, response rate was 54% and the local tumor control rate 83%. T2 signal intensity was found to be the principal predictive factor of response to GKS, namely negative predictive factor. Other variables such as age, sex, tumor volume, dose, duration from initial diagnosis to GKS, and previous systemic therapies failed to show significant relationships with treatment response by multivariate analysis. Conclusion : Careful evaluation of the radiological characteristics of brain metastases from RCC is important prior to GKS because MRI heterogeneity has predictive value in terms of determining initial tumor response.


  • 주제어

    Renal cell carcinoma .   Brain metastasis .   Gamma knife surgery .   Tumor control .   Radiological characteristics.  

  • 참고문헌 (19)

    1. Godley PA, Ataga KI : Renal cell carcinoma. Curr Opin Oncol 12 : 260-264, 2000 
    2. Goodman KA, Sneed PK, McDermott MW, Shiau CY, Lamborn KR, Chang S, et al : Relationship between pattern of enhancement and local control of brain metastases after radiosurgery. Int J Radiat Oncol Biol Phys 50 : 139-146, 2001 
    3. Hiwatashi A, Kinoshita T, Moritani T, Wang HZ, Shrier DA, Numaguchi Y, et al : Hypointensity on diffusion-weighted MRI of the brain related to T2 shortening and susceptibility effects. AJR Am J Roentgenol 181 : 1705-1709, 2003 
    4. Hoshi S, Jokura H, Nakamura H, Shintaku I, Ohyama C, Satoh M, et al : Gamma-knife radiosurgery for brain metastasis of renal cell carcinoma : results in 42 patients. Int J Urol 9 : 618-625; discussion 626; author reply 627, 2002 
    5. Shiau CY, Sneed PK, Shu HK, Lamborn KR, McDermott MW, Chang S, et al : Radiosurgery for brain metastases : relationship of dose and pattern of enhancement to local control. Int J Radiat Oncol Biol Phys 37 : 375-383, 1997 
    6. Shuto T, Inomori S, Fujino H, Nagano H : Gamma knife surgery for metastatic brain tumors from renal cell carcinoma. J Neurosurg 105 : 555-560, 2006 
    7. Wowra B, Siebels M, Muacevic A, Kreth FW, Mack A, Hofstetter A : Repeated gamma knife surgery for multiple brain metastases from renal cell carcinoma. J Neurosurg 97 : 785-793, 2002 
    8. Chang EL, Selek U, Hassenbusch SJ, Maor MH, Allen PK, Mahajan A, et al : Outcome variation among “radioresistant” brain metastases treated with stereotactic radiosurgery. Neurosurgery 56 : 936-945; discussion 936-945, 2005 
    9. Brem S, Panattil JG : An era of rapid advancement : diagnosis and treatment of metastatic brain cancer. Neurosurgery 57 : S5-9; discusssion S1-4, 2005 
    10. Payne BR, Prasad D, Szeifert G, Steiner M, Steiner L : Gamma surgery for intracranial metastases from renal cell carcinoma. J Neurosurg 92 : 760-765, 2000 
    11. Goyal S, Prasad D, Harrell F, Matsumoto J, Rich T, Steiner L : Gamma knife surgery for the treatment of intracranial metastases from breast cancer. J Neurosurg 103 : 218-223, 2005 
    12. Mori Y, Kondziolka D, Flickinger JC, Logan T, Lunsford LD : Stereotactic radiosurgery for brain metastasis from renal cell carcinoma. Cancer 83 : 344-353, 1998 
    13. Mathieu D, Kondziolka D, Cooper PB, Flickinger JC, Niranjan A, Agarwala S, et al : Gamma knife radiosurgery in the management of malignant melanoma brain metastases. Neurosurgery 60 : 471-481; discussion 481-482, 2007 
    14. Hernandez L, Zamorano L, Sloan A, Fontanesi J, Lo S, Levin K, et al : Gamma knife radiosurgery for renal cell carcinoma brain metastases. J Neurosurg 97 : 489-493, 2002 
    15. Brown PD, Brown CA, Pollock BE, Gorman DA, Foote RL : Stereotactic radiosurgery for patients with “raIdioresistant” brain metastases. Neurosurgery 51 : 656-665; discussion 665-667, 2002 
    16. Muacevic A, Siebels M, Tonn JC, Wowra B : Treatment of brain metastases in renal cell carcinoma : radiotherapy, radiosurgery, or surgery? World J Urol 23 : 180-184, 2005 
    17. Sheehan JP, Sun MH, Kondziolka D, Flickinger J, Lunsford LD : Radiosurgery in patients with renal cell carcinoma metastasis to the brain : long-term outcomes and prognostic factors influencing survival and local tumor control. J Neurosurg 98 : 342-349, 2003 
    18. Amendola BE, Wolf AL, Coy SR, Amendola M, Bloch L : Brain metastases in renal cell carcinoma : management with gamma knife radiosurgery. Cancer J 6 : 372-376, 2000 
    19. Peterson AM, Meltzer CC, Evanson EJ, Flickinger JC, Kondziolka D : MR imaging response of brain metastases after gamma knife stereotactic radiosurgery. Radiology 211 : 807-814, 1999 

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