ИСТИНА

BACKGROUND: Brain metastases (BM) is a significant problem in patients with metastatic renal-cell carcinoma (RCC). Local and systemic therapies including stereotactic radiosurgery (SRS) are rapidly evolving, necessitating reassessments of outcomes for modern patient management. PURPOSE: The study purpose was to evaluate the impact of gamma knife radiosurgery (GKRS) alone on the overall survival and intracranial recurrence rates in brain metastasis patients from RCC. PATIENTS AND METHODS: The RCC patients with BM treated with SRS were reviewed. 74 patients were identified with BM treated between 2010 and 2015. A total of 309 BM were treated with SRS with 1 to 24 BMs treated per session (median, 2 BMs). The median (range) of volume was 4,47 cc (0,3-19,8). The median (range) SRS treatment dose was 20 (15-24) Gy. RESULTS: The median overall survival was 10 months (95% CI 6,5-13,3). Survival after 1-year was 43,2% for all patients. Survival was not statistically different between patients with < 5 BM versus ≥ 5 BM (P = 0,4583). Local control after 12 months was achieved in 87,1% patients. Progression-free survival after 12 months was 48,4%. Аccording to multivariate analysis, favorable prognostic factors were KPS >70 and total target volume BMs <5 cm3. CONCLUSION: SRS is effective in controlling BM in patients with RCC. Over half of treated patients survive one year, and no differences in survival were noted in patients with ≥ 5 BM metastases in comparison with those, who had < 5 BM. Factors predicting better survival were high functional status and low total target volume BMs