Gamma-knife radiosurgery as an optimal treatment modality for brain metastases from epithelial ovarian cancer

Central Nervous System Involvement from Epithelial Ovarian Cancer

“…(Anupol, 2002;Brown III, 2005;Chen, 2009;Cohen, 2004;Cormio, 1995, 2003b, Cormio, 2011aD'Andrea, 2005;Kastritis, 2006;Kim, 2007;Kumar, 2003;Lee, 2008;Sanderson, 2002;Sehouli, 2010;Tay & Rajesh, 2005). However Kolomainen et al demonstrated in their series that a brain involvement could be seen quite frequently (one third of their patients) also in patients with FIGO stage I.…”

“…Other symptoms that are often described are vomiting, confusions, visual disturbances, paresis, and weakness, loss of consciousness, seizures, and dizziness. (Cohen, 2004;Cormio, 2011a;D'Andrea, 2005;Lee, 2008;Pectasides, 2006;Tay &Rajesh, 2005) The leptomeningeal involvement usually causes an arise of the intracranial pressure associated with hydrocephalus; these patients more frequently than the others complain also for bowel of bladder dysfunctions, while the involvement of cranial nerves can also be possible. (Pectasides, 2006;Vitaliani R, 2009) In our recent series of 20 patients, all patients were symptomatic at the moment of the diagnosis; most of them complain of headache, vomiting and dizziness with or without balance disturbances, less frequent symptoms were diplopia, convulsions, amnesia, confusion and pain.…”

“…In fact, while in 1995 the therapy was given more with palliative intent, nowadays clinicians are more likely to administer more aggressive and multimodal treatments, with the intent of both improving the quality of life and the overall survival. (Anupol, 2002;Brown III, 2005;Chen, 2009;Cohen, 2004;Cormio, 1995;Cormio, 2003b;Cormio, 2011a;D'Andrea, 2005;Kastritis, 2006;Kim, 2007;Lee, 2008;Sanderson, 2002;Sehouli, 2010;Tay & Rajesh, 2005) Future efforts can be put on one side, on the improvement of early diagnosis by the investigation of the role of new imaging techniques such as positron emission tomography and magnetic resonance spectroscopy in the detection of brain metastases, and on the other side on the improvement of treatment modality with higher efficacy and lower morbidity like the new radio surgical techniques. Although many authors agree that a multimodal approach results in better prognosis, further studies should be done to fix some guidelines for the treatment of these patients.…”

Outcomes Following Gamma Knife for Metastases

“…One large retrospective study of 1,702 patients comparing SRS+WBRT to WBRT alone also reported a significant survival benefit for patients receiving SRS for all three RPA classes (Sanghavi, 2001). Three other studies comparing SRS alone to WBRT alone found that SRS patients lived significantly longer (Kocher, 2004;Lee, 2008;Rades, 2007b), while one found no significant survival difference (Datta, 2004).…”

Treatment in patients with ovarian cancer metastasizing to the brain

“…Методом выбора при экстракраниальной генерализации процесса при не-больших внутримозговых очагах без масс-эффекта явля-ется СРХГН. Безрецидивная выживаемость при исполь-зовании радиохирургии в подобной ситуации составляет 29 мес, при применении ОВГМ -всего 6 [36]. Однако облучение отдельных очагов не обеспечивает контроля над возможными, еще не реализовавшимися, микроме-тастазами в головном мозге.…”