Abstract

Abstract
BACKGROUND: Brain metastasis represent a significant source of mortality in patients with systemic cancer,they are neoplasms that originate in tissues outside (CNS) and spread to the brain. SRS is the precise delivery of focal radiotherapy to targets within the brain,SRS is delivered using dedicated radiosurgery platforms such as the Gamma Knife.
PATIENTS AND METHODS: This is a prospective clinical study performed in Saad Al-Witry Neuroscience Hospital,to evaluate the role of gamma knife radiosurgery as a treatment of secondary metastatic depending on tumor volume, peritumoral edema and presenting features with their effect on quality of life and survival, between January 2019 to January 2020. Mean age was (63.02± 11.98),21 patients were >65 years, while 29 patients were <65 years.13 of patients were males and 37 were females.Lung cancer was primary lesion in 68%, breast cancer in 22%,both prostate cancer and RCC were 4%. 64% of patients was without previous brain treatment, only 36% was with previous treatment. Majority of patients had headache 44%, followed by weakness 20%, seizure 16% Primary brain MRI with contrast assessed the tumor volume, peritumoral edema and its number then follow up brain MRI with contrast done after 6 ,12 months.
RESULTS: After 12 months ; mean tumor volume post (GKRS) regressed from 6.48cm3 to 3.38cm3. Age of patients <65 years, KPS
>70, patients with small tumor volume and patients without previous treatment (surgery, chemotherapy and WBRT) had good prognosis. Mean KPS improved from (76) to (87.5) Life expectancy was 20% dead, 80% was alive.
CONCLUSION: GKRS is efficient and safe in treatment of secondary brain metastasis, less than 65 years, KPS more than 70, decrease in tumor volume post . are associated with increased survival rate, improvement in clinical features associated with better quality of life, multiplicity of metastasis is an ominous sign of mortality.