ĐÁNH GIÁ KẾT QUẢ XẠ PHẪU GAMMA KNIFE UNG THƯ DI CĂN THÂN NÃO TẠI BỆNH VIỆN K

Abstract

Objectives: Brain metastasis is the most common malignant tumor of the brain, about 10 times more common than primary brain cancer. Brain metastases are common in 15 - 40% of cancer patients. However, brain stem metastases are rare, accounting for only about 3 - 5% of all brain metastases. Most brainstem metastases cannot be treated surgically, so radiation therapy is widely used. Whole-brain radiation therapy is considered a main treatment method, but it damages many healthy brain tissues and causes many complications. Radiosurgery is proving effective in treating brain stem metastatic cancer, but is generally limited by concerns about side effects when using high radiation doses. Our study aims to evaluate the results of treatment of brain stem metastatic cancer by radiosurgery. Methods: We analyzed 57 patients with brain stem metastases from July 2019 to May 2024. Selected patients have brain metastases from 1 to 10 tumors, including brain stem metastatic lesions, KPS score ≥ 60. Patients were treated by stereotactic radiosurgery using Leksell Gamma Knife ICON unit (Elekta AB) with dose of 20 – 24, 18 – 20Gy for lesions measuring < 2, 2.1 – 3 cm, respectively. Patients were assessed for clinical symptoms and imaging response according to RANO criteria at 6, 12 months and survival outcomes. Results: In our study, the 6-month brain stem tumor control rate was 77.2%. Overall survival rate at 6 months was 70,5%, 12 months was 42,2%, 24 months was 30,8%, overall survival time was 11,0 ± 1,5 months. Conclusion: Combination Gamma Knife radiosurgery is an effective treatment for brain stem metastases.