Abstract
Intracranial metastatic prostate carcinoma is rare. We sought to determine the clinical outcomes after Gamma Knife® stereotactic radiosurgery (GKSRS) for patients with intracranial prostate carcinoma metastases. We studied data from 10 patients who underwent radiosurgery for 15 intracranial metastases (9 dural-based and 6 parenchymal). Six patients had radiosurgery for solitary tumors and four had multiple tumors. The primary pathology was adenocarcinoma (eight patients) and small cell carcinoma (two patients). All patients received multimodality management for their primary tumor (including resection, radiation therapy, androgen deprivation therapy) and eight patients had evidence of systemic disease at time of radiosurgery. The mean tumor volume was 7.7 cm3 (range 1.1–17.2 cm3) and a median margin dose of 16 Gy was administered. Two patients had progressive intracranial disease in spite of fractionated partial brain radiation therapy (PBRT) prior to SRS. A local tumor control rate of 85% was achieved (including patients receiving boost, upfront and salvage SRS). New remote brain metastases developed in three patients (33%) and one patient had repeat SRS for tumor recurrence. The median survival after radiosurgery was 13 months and the 1-year survival rate was 60%. SRS was a well tolerated and effective therapy either alone or as a boost to fractionated radiation therapy in the management of patients with intracranial prostate carcinoma metastases.
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Acknowledgements
The work described in this report was funded by a grant (to T.F.) from the Irish Institute of Clinical Neuroscience, the Ethicon Foundation Fund Royal College of Surgeons of Edinburgh, Friends of the Royal Travel Fund, Northern Ireland Medical & Dental Training Agency and Congress of Neurological Surgeons Lars Leksell Fellowship.
Conflict of interest/Disclosure
Drs Lunsford, Kondziolka and Niranjan are consultants with AB Elekta. Dr Lunsford is a stockholder in AB Elekta.
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Flannery, T., Kano, H., Niranjan, A. et al. Stereotactic radiosurgery as a therapeutic strategy for intracranial metastatic prostate carcinoma. J Neurooncol 96, 369–374 (2010). https://doi.org/10.1007/s11060-009-9966-5
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DOI: https://doi.org/10.1007/s11060-009-9966-5