RESUMO
To evaluate the effectiveness of radiosurgery without whole brain radiotherapy in the palliative treatment of melanoma brain metastases, we retrospectively assessed the results in 35 patients: 4 with a solitary brain metastasis, 13 with a single brain metastasis and metastases elsewhere and 18 with multiple brain metastases. The local control rate was 98.2% (55/56 metastases) at 3 months. Median survival was 22 months in patients with a solitary brain metastasis, 7.5 months in patients with a single brain metastasis and metastases elsewhere, and 4 months in patients with multiple brain metastases. Complications were unusual and surgery was required in 2 of 35 patients. These results show for the first time that melanoma patients with a unique brain metastasis with or without metastases elsewhere clearly benefit from tumour control easily obtained by radiosurgery. Although the comparison of radiosurgery with surgery and/or whole brain radiotherapy cannot be adequately addressed, radiosurgery alone seems to provide similar results with lower morbidity and impact on quality of life.
Assuntos
Neoplasias Encefálicas/cirurgia , Melanoma/cirurgia , Cuidados Paliativos/métodos , Radiocirurgia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/secundário , Humanos , Melanoma/diagnóstico por imagem , Melanoma/secundário , Pessoa de Meia-Idade , Compostos de Nitrosoureia/uso terapêutico , Compostos Organofosforados/uso terapêutico , Radiocirurgia/efeitos adversos , Análise de Sobrevida , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Based on a series of 7 cases the original characteristics of neuroblastomas are described, these tumors being of neuronal origin and exhibiting such constant calcifications and median line sites that they can be evoked in spite of their rareness.
