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Journal of Korean Neurosurgical Society 2009;46(3): 245-251.
doi: https://doi.org/10.3340/jkns.2009.46.3.245
Clinical Analysis of Novalis Stereotactic Radiosurgery for Brain Metastases.
Hae Won Gu, Moon Jun Sohn, Dong Joon Lee, Hye Ran Lee, Chae Heuck Lee, C Jin Whang
1Department of Neurosurgery, Novalis Radiosurgery Center, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea. mjsohn@paik.ac.kr
2Department of Internal Medicine, Novalis Radiosurgery Center, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea.
The authors analyzed the effectiveness and therapeutic response of Novalis shaped beam radiosurgery for metastatic brain tumors, and the prognostic factors which influenced the outcome. METHODS: We performed a retrospective analysis of 106 patients who underwent 159 treatments for 640 metastatic brain lesions between January 2000 and April 2008. The pathologies of the primary tumor were mainly lung (45.3%), breast (18.2%) and GI tract (13.2%). We classified the patients using Radiation Therapy Oncology Group Recursive Partitioning Analysis (RPA) and then analyzed the survival and prognostic factors according to the Kaplan Meier method and univariate analysis. RESULTS: The overall median actuarial survival rate was 7.3 months from the time of first radiosurgery treatment while 1 and 2 year actuarial survival estimates were 31% and 14.4%, respectively. Median actuarial survival rates for RPA classes I, II, and III were 31.3 months, 7.5 months and 1.7 months, respectively. Patients' life spans, higher Karnofsky performance scores and age correlated closely with RPA classes. However, sex and the number of lesions were not found to be significantly associated with length of survival. CONCLUSION: This result suggests that Novalis radiosurgery can be a good treatment option for treatment of the patients with brain metastases.
Key Words: Brain metastasis; Stereotactic radiosurgery; Novalis system; Prognostic factors; RPA classification; Outcome evaluation
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