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Neurosurgery. 2010 Dec;67(6):1515-22. doi: 10.1227/NEU.0b013e3181fa239e.

The Louisiana State University experience in the management of single small cerebellar metastasis.

Author information

1
Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71103-33932

Abstract

BACKGROUND:

Cerebellar metastasis is often believed to be a more immediately life-threatening complication than brain metastasis in other locations. It is considered a negative prognostic factor in patients with systemic cancers. Despite its clinical importance and technological advances, the survival outcomes of patients with single small cerebellar metastases are rarely studied.

OBJECTIVE:

To retrospectively evaluate our experience in the management of patients with single small cerebellar metastasis and compare the treatment modalities.

MATERIAL AND METHODS:

A total of 35 patients with single small cerebellar metastasis were included in this retrospective analysis. Of the 35 patients, 24 had surgery followed by whole-brain radiation therapy and 11 had Gamma Knife radiosurgery alone.

RESULTS:

The median survival for the whole cohort was 5.6 months after the intervention. No significant differences were noted in median survival between the surgery plus whole-brain radiation therapy and the Gamma Knife radiosurgery alone groups (6.3 months: 95% confidence interval [CI], 4.0-8.6; vs 5.0 months: 95% CI, 1.9-8.1; P=.9). There was no difference in the median time to local progression, distance progression, and overall progression between the 2 groups. Patients with hydrocephalus had a significantly lower survival rate (median, 3.3 months; 95% CI, 0.0-6.6) compared with those without hydrocephalus (median, 6.9 months; 95% CI, 4.4-9.8; P=.02). In the Cox regression model, the significant predictor of survival was hydrocephalus (P=.01; hazard ratio, 3.5; 95% CI, 1.3-9.1) after propensity score adjustment.

CONCLUSION:

Treatment with Gamma Knife radiosurgery alone and surgery plus whole-brain radiation therapy were both efficacious in patients with single small cerebellar metastasis. Overall survival was nearly identical in both treatment groups.

PMID:
21107182
DOI:
10.1227/NEU.0b013e3181fa239e
[Indexed for MEDLINE]

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