RADIOSURGERY WITHOUT WHOLE-BRAIN RADIOTHERAPY IN MELANOMA BRAIN METASTASES

To evaluate the effectiveness of radiosurgery without whole brain radi otherapy 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 el sewhere and 18 with multiple brain metastases. The local control rate was 98.2% (55/56 metastases) at 3 months. Median survival was 22 month s 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 unusua l 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 contr ol easily obtained by radiosurgery. Although the comparison of radiosu rgery with surgery and/or whole brain radiotherapy cannot be adequatel y addressed, radiosurgery alone seems to provide similar results with lower morbidity and impact on quality of life. (C) 1998 Published by E lsevier Science Ltd. All rights reserved.