Radiosurgery in the management of brain metastasis: a retrospective single-center study comparing Gamma Knife and LINAC treatment

OBJECTIVEThe authors present a retrospective analysis of a single-center experience with treatment of brain metastases using Gamma Knife (GK) and linear accelerator (LINAC)–based radiosurgery and compare the results.METHODSFrom July 2010 to July 2012, 63 patients with brain metastases were treated with radiosurgery. Among them, 28 (with 83 lesions) were treated with a GK unit and 35 (with 47 lesions) with a LINAC. The primary outcome was local progression–free survival (LPFS), evaluated on a per-lesion basis. The secondary outcome was overall survival (OS), evaluated per patient. Statistical analysis included standard tests and Cox regression with shared-frailty models to account for the within-patient correlation.RESULTSThe mean follow-up period was 11.7 months (median 7.9 months, range 1.7–32 months) for GK and 18.1 months (median 17 months, range 7.5–28.7 months) for LINAC. The median number of lesions per patient was 2.5 (range 1–9) in the GK group and 1 (range 1–3) in the LINAC group (p < 0.01, 2-sam...