The Role of Stereotactic Radiotherapy for the Treatment of Melanoma and Renal Cell Carcinoma Brain Metastases
Melike PEKYÜREK VARAN1,Gökhan YAPRAK1,Emriye ALGÜL1,Duygu GEDIK1,Naciye IŞIK1
1Department of Radiation Oncology, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul-Türkiye DOI : 10.5505/tjo.2023.3853 OBJECTIVE
The best radiotherapeutic approach for brain metastasis (BM) is highly controversial. Compared to Whole-brain radiotherapy, the stereotactic radiotherapy (SRT) technique allows for focused ablative doses to target lesions. We aim to present our clinical experience with SRT as a treatment option for radioresistant BM in melanoma and renal cell carcinoma (RCC).

We identified 46 BM from radioresistant histologies (26 melanoma and 20 RCC) treated with SRT in our clinic between 2010 and 2020 in 29 patients (18 melanoma and 11 RCC). The robotic linear acceleratorbased CyberKnife system was used to administer SRT.

SRT was performed in a median of 2 fractions, and the median dose was 20 Gy. The median follow-up was 8 months. Median overall survival after SRT was 8 months, and 1- and 2-year survival rates were 37.9 and 14.2%, respectively. Median local progression-free survival (LPFS) was not reached, and 1- and 2-year LPFS were both 83.4%. Median distant brain progression-free survival (DBPFS) was 14 months, and 1- and 2-year DBPFS rates were 54.2 and 23.2%, respectively. Radionecrosis occurred in 2 metastases (4.3%).

SRT is a valuable treatment option for RCC and melanoma brain metastases with reasonable local and distant brain control and limited toxicity. Keywords : Brain metastasis; melanoma; radioresistant; renal cell carcinoma; stereotactic radiotherapy