Treatment of patients with multiple brain metastases by isolated radiosurgery: Toxicity and survival

Table 1 Descriptive characteristics of 55 patients treated by radiosurgery for multiple brain metastases (%)

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Characteristic	NP (n = 35)	P (n = 20)	P value
Age at treatment (yr)1	62 (51-67)	53 (42-58)	0.032
Age (yr)			0.162
< 55	15 (42.9)	13 (65)
≥ 55	20 (57.1)	7 (35)
Gender			0.391
Female	22 (62.9)	15 (75)
Male	13 (37.1)	5 (25)
Number of lesions1	5 (4-7)	5 (4-7)	0.89
Target volumes1	5.4 (2.2-9.9)	2.9 (1.63-4.3)	0.08
Primary site			0.85
Lung	16 (45.7)	7 (35)
Breast	8 (22.9)	7 (35)
Melanoma	8 (22.9)	6 (30)
Others	3 (8.6)	0
KPS	n = 34	n = 20	0.194
≤ 70	6 (17.6)	7 (35)
> 70	28 (82.4)	13 (65)
DS-GPA	n = 31	n = 20	0.7
0-1	11 (35.5)	8 (40)
1.5-2	14 (45.2)	7 (35)
2.5-3	4 (12.9)	2 (10)
3-4	2 (6.5)	3 (15)
RPA	n = 34	n = 20	0.751
Class 1	2 (5.9)	1 (5)
Class 2	28 (82.4)	15 (75)
Class 3	4 (11.8)	4 (20)
SIR1	n = 34	n = 20	0.104
	4 (4-6)	5 (4-6.5)
Prescription dose (Gy)			0.133
20	8 (22.9)	1 (5)
18	27 (77.1)	19 (95)

¹Median and interquartile range (p25-p75).

P < 0.05 was considered significant. P: Previous irradiation before radiosurgery; NP: No previous irradiation; KPS: Karnofsky performance status; DS-GPA: Diagnosis-specific graded prognostic assessment; RPA: Recursive partitioning analyses; SIR: Score index for radiosurgery.

Table 2 Incidence of toxicities

Toxicity	n of patients	Percentage (%)
Headache	21	38.2
Convulsion	4	7.3
Focal deficit	5	9.1
Drop in level of consciousness	3	5.5
Fatigue	8	14.5
Nausea or vomiting	6	10.9
Mental confusion	1	1.8

Table 3 Number of reported cases of toxicity per period after treatment

Period (mo)	n of patients	Percentage
t < 1	4	12.5
1 ≤ t < 3	13	40.6
3 ≤ t < 6	6	18.8
6 ≤ t < 9	6	18.8
9 ≤ t < 12	2	6.2
t ≥ 12	1	3.1

Table 4 Incidence of toxicity in each group of patients, n (%)

	Group 1	Group 2	Group 3	Group 4
Headache	10 (58.8)	4 (57.1)	2 (66.7)	5 (100)
Convulsion	1 (5.9)	1 (14.3)	1 (33.3)	1 (20)
Focal deficit	3 (17.6)	1 (14.3)		1 (20)
Drop in level of consciousness	2 (11.8)		1 (33.3)
Fatigue	6 (35.3)	1 (14.3)	1 (33.3)
Nausea or vomiting	5 (29.4)	1 (14.3)
Mental confusion	1 (5.9)
Total	28	8	5	7