Successful treatment of brain metastases from ovarian cancer using gamma-knife radiosurgery

We describe a case with multiple brain metastases from ovarian cancer which were successfully treated by a multimodality approach including gamma-knife radiosurgery. This case was diagnosed as epithelial ovarian cancer, FIGO stage IV, with supraclavicular lymph node metastasis and malignant pleural effusion. She underwent cisplatin-based chemotherapy before and after cytoreductive surgery for 9 months and then achieved clinical complete remission for 27 months. Multiple brain metastases occurred 36 months after the initial diagnosis of ovarian cancer. She had no recurrent lesions outside the brain. She underwent surgical resection of the two accessible lesions and then gamma-knife radiosurgery for another unresectable lesion after 30 Gy cranial irradiation. The multimodal treatment including gamma-knife radiosurgery has produced complete remission of multiple brain. metastases for 21 months with good quality of life. Accordingly, at the moment, i.e., 5 years after the initial diagnosis of the disease, she remains in a disease-free state. (C) 1997 Academic Press.