Survival and prognostic factors in patients with brain metastases from malignant melanoma

被引:47
作者
Meier, S
Baumert, BG
Maier, T
Wellis, G
Burg, G
Seifert, B
Dummer, R
机构
[1] Univ Zurich Hosp, Dept Dermatol, Dermatol Klin, CH-8091 Zurich, Switzerland
[2] Univ Zurich Hosp, Clin & Policlin Radiat Oncol, CH-8091 Zurich, Switzerland
[3] Klin Pk, Dept Radiosurg, Zurich, Switzerland
[4] Univ Zurich, Inst Social & Prevent Med, Dept Biostat, CH-8006 Zurich, Switzerland
来源
ONKOLOGIE | 2004年 / 27卷 / 02期
关键词
melanoma; brain metastases; survival; prognostic factors; radiosurgery; stereotactic; temozolomide;
D O I
10.1159/000076903
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Aim: We wanted to determine the factors influencing survival in a retrospective review of patients with melanoma brain metastases to permit more specific recommendations regarding therapy. Patients and Methods: We reviewed the data of 100 patients treated at the Department of Dermatology and Radiation Oncology, University of Zurich, and the Klinik im Park, Zurich. Information on potential prognostic factors ( age, sex, location of the primary tumor, Clark level, Breslow index, histological type, number of brain metastases, stage at initial diagnosis, location of brain metastases, and therapy) was collected from the medical records of 100 patients treated between 1966 and 2002. Univariate and multivariate analyses were performed to identify significant prognostic factors. Results: The overall median survival time was 4.8 months, with 6-month, 1-year and 2-year survival percentages of 36, 14 and 5%, respectively. Univariate analysis indicated that survival correlated significantly with radiotherapy ( partial and whole brain), surgery, stereotactic radiosurgery, chemotherapy, Clark level and Breslow index. Treatment with temozolomide (p = 0.052) and number of brain metastases (p = 0.07) failed to be statistically significant. Multivariate analysis confirmed radiotherapy (partial and whole brain), surgery, stereotactic radiosurgery, chemotherapy and the location of brain metastases as independent and significant prognostic factors of survival. The remaining factors did not reach statistical significance in multivariate analysis. Conclusion: Radiotherapy, chemotherapy and especially surgery and stereotactic radiosurgery seem to significantly prolong survival, as shown by multivariate analysis. Treatment with temozolomide will possibly play an important role in the future management of patients with brain metastases from cutaneous melanoma, but further prospective studies to verify this assumption are urgently needed.
引用
收藏
页码:145 / 149
页数:5
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