Stereotactic irradiation using a linear accelerator for brain metastasis from renal cell carcinoma |
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Authors: | Kazuyuki Kawashima Hiroki Shirato Akira Takamura Nobuo Shinohara Yutaka Sawamura Kazuo Miyasaka |
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Institution: | (1) Department of Radiology, Hokkaido University School of Medicine, SW1W16 Chuo-ku, 060 Sapporo, Japan;(2) Department of Radiology, Asahikawa Kousei Hospital, Hokkaido, Japan;(3) Department of Urology, Hokkaido University School of Medicine, Sapporo, Japan;(4) Department of Neurosurgery, Hokkaido University School of Medicine, Sapporo, Japan |
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Abstract: | Background The role of stereotactic irradiation using a linear accelerator for brain metastasis from renal cell carcinoma was investigated.
Methods Fifteen brain metastases in 11 patients with a history of renal cell carcinoma were treated using convergent narrow x-ray
beams from a linear accelerator and rigid fixation of the head with a stereotactic frame. Twelve metastatic tumors in8 patients
were irradiated with 25 Gy at the center in a single fraction, and single tumors in 3 patients received the following doses:
25 Gy in 5 fractions, 28 Gy in 3 fractions, or 35 Gy in 4 fractions
Results The actuarial local control rate at 12 months was 90.6%. Twelve (92%) of 13 lesions that produced neurologic symptoms before
stereotactic irradiation showed an improvement of symptoms. No complication related to the irradiation was observed. The median
survival time was 6 months.
Conclusion Stereotactic irradiation is more effective in achieving local control than is conventional radiotherapy, and achieves improvement
in symptoms and survival rates similar to those of surgical resection of the brain metastasis from renal cell carcinoma. Urologists
and oncologists should be aware of the usefulness of stereotactic radiation in the management of patients with renal cell
carcinoma. |
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Keywords: | stereotactic radiosurgery radiotherapy brain metastasis renal cell carcinoma |
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