Gamma Knife Radiosurgery for Metastatic Melanoma: An Analysis of Survival, Outcome, and Complications

Abstract

Although metastatic melanoma to the brain continues to have a foreboding prognosis for long-term survival, gamma knife radiosurgery seems to be a relatively safe, noninvasive, palliative therapy, halting or reversing neurological progression in 77.8% of treated patients (35 of 45 patients). The survival rate matches or exceeds those previously reported for surgery and other forms of radiotherapy. Only 7.7% of the patients in our study population who died as a result of metastatic melanoma (2 of 26 patients) died as a result of neurological disease. The routine use of therapeutic level antiseizure medication is emphasized, considering the findings of our review.

Intracerebral malignant melanoma presenting as an Arteriovenous Malformation: case report and literature review

“…Malignant melanoma (MM) is one of the most common tumors that metastasize to the brain [1], with nonspecific presentation as the other intracranial lesions [2,3]. About 70.6% of melanoma patients had cerebral metastasis at younger than 65 years of age [4].…”

Diagnosis and Treatment Options for Brain Metastasis of Melanoma

“…Clinically, stabilization or improvement of neurological symptoms after treatment was noted in about 78 to 100 percent of patients [104,106]. Patients also demonstrated a median survival time comparable to that of surgical resection which was found to be about 5 to 14 months [106][107][108][109][110]. However, as with the other treatment modalities, patient factors and selection affects outcome.…”

“…For metastatic melanoma to the brain, the local control rate was shown to be approximately 90 to 97 percent [103][104][105]. Clinically, stabilization or improvement of neurological symptoms after treatment was noted in about 78 to 100 percent of patients [104,106]. Patients also demonstrated a median survival time comparable to that of surgical resection which was found to be about 5 to 14 months [106][107][108][109][110].…”

“…Patients with solitary brain lesions additionally demonstrated longer survival times than those patients with multiple brain lesions. However, an increased number of metastases should not be a reason to withhold SRS treatment [106][107][108][109][110]. Combination therapy has been studied and utilized in the treatment of metastatic melanoma to the brain.…”

The role of stereotactic radiosurgery in the management of secondary pontine tumors

“…[2] Specifically, the lack of efficacy and the cognitive and behavioral consequences of WBRT have prompted clinicians to select patients for alternative therapies. [3] Interestingly, radiosurgery provides a safe and effective treatment for many patients with brain metastases. [4] An increasing number of patients are being referred for stereotactic radiosurgery (SRS) as the primary intervention for their intracranial pathological abnormalities [3] and it is estimated that several thousands of cases with metastatic brain tumors have been treated with Gamma Knife radiosurgery (GKRS) so far.…”