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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Affiliation: | (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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