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  • 标题:Optimal Treatment Decision for Brain Metastases of Unknown Primary Origin: The Role and Timing of Radiosurgery
  • 本地全文:下载
  • 作者:Han, Hyun Jin ; Chang, Won Seok ; Jung, Hyun Ho
  • 期刊名称:Brain Tumor Research and Treatment
  • 印刷版ISSN:2288-2405
  • 出版年度:2016
  • 卷号:4
  • 期号:2
  • 页码:107-110
  • DOI:10.14791/btrt.2016.4.2.107
  • 语种:English
  • 出版社:The Korean Brain Tumor Society and The Korean Society for Neuro-Oncology
  • 摘要:Background

    Up to 15% of all patients with brain metastases have no clearly detected primary site despite intensive evaluation, and this incidence has decreased with the use of improved imaging technology. Radiosurgery has been evaluated as one of the treatment modality for patients with limited brain metastases. In this study, we evaluated the effectiveness of radiosurgery for brain metastases from unknown primary tumors.

    Methods

    We retrospectively evaluated 540 patients who underwent gamma knife radiosurgery (GKRS) for brain metastases radiologically diagnosed between August 1992 and September 2007 in our institution. First, the brain metastases were grouped into metachronous, synchronous, and precocious presentations according to the timing of diagnosis of the brain metastases. Then, synchronous and precocious brain metastases were further grouped into 1) unknown primary; 2) delayed known primary; and 3) synchronous metastases according to the timing of diagnosis of the primary origin. We analyzed the survival time and time to new brain metastasis in each group.

    Results

    Of the 540 patients, 29 (5.4%) presented precocious or synchronous metastases (34 GKRS procedures for 174 lesions). The primary tumor was not found even after intensive and repeated systemic evaluation in 10 patients (unknown primary, 34.5%); found after 8 months in 3 patients (delayed known primary, 1.2%); and diagnosed at the same time as the brain metastases in 16 patients (synchronous metastasis, 55.2%). No statistically significant differences in survival time and time to new brain metastasis were found among the three groups.

    Conclusion

    Identification of a primary tumor before GKRS did not affect the patient outcomes. If other possible differential diagnoses were completely excluded, early GKRS can be an effective treatment option for brain metastases from unknown primary tumor.

  • 关键词:Neoplasm metastasis; Neoplasms, Unknown primary; Radiosurgery
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