Evaluation of Different Score Index for Predicting Prognosis in Gamma Knife Radiosurgical Treatment for Brain Metastasis

Franzin, Alberto; Snider, Silvia; Picozzi, Piero; Bolognesi, Angelo; Serra, Carlo; Vimercati, A; Passarin, O.; Mortini, Pietro

doi:10.1016/j.ijrobp.2008.08.062

Cited by 6 publications

(1 citation statement)

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“…The prognoses of patients with brain metastases arising from NSCLC varies greatly with the median survival time ranging from 6.9 to 46.8 months (3). Several high-technique models, such as diagnosis-specific graded prognostic assessment (DS-GPA), Graded Prognostic Assessment for Lung Cancer Using Molecular Markers (Lung-molGPA), score index for radiosurgery (SIR), and basic score for brain metastases (BSBM), are used to evaluate the prognosis of NSCLC patients (3)(4)(5)(6), but the techniques are ineffective in evaluating the prognosis of NSCLC patients with brain oligo-metastasis treated with fractionated stereotactic radiotherapy (FSRT). FSRT has a higher local control rate and fewer side effects than stereotactic radiosurgery (SRS) therapy and has thus been widely used in the clinic.…”

Section: Introductionmentioning

confidence: 99%

Pretreatment lymphocyte-to-monocyte ratio as a prognostic factor and influence on dose-effect in fractionated stereotactic radiotherapy for oligometastatic brain metastases in non-small cell lung cancer patients

et al. 2023

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BackgroundStudies on the prognostic factors for patients with brain oligo-metastasis treated with fractionated stereotactic radiotherapy (FSRT) usually focus on the size of metastatic tumor and radiation dose. Some inflammatory indicators have predictive value in non-small cell lung cancer (NSCLC) with brain metastasis receiving stereotactic radiotherapy. However, the prognostic value of inflammatory indicators in NSCLC patients with brain oligo-metastasis treated with FSRT, and their effect on radiotherapy dose is unknown.MethodsA total of 95 advanced NSCLC patients with brain oligo-metastasis who had undergone FSRT treatment at Ningbo Medical Center Lihuili Hospital between January 2015 and April 2022 were enrolled into the study. Neutrophil to lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), tumor diameter and biologically effective dose (BED10) were analyzed using Chi-square test. Univariate and multivariate Cox regressions were used to identify predictors of survival.ResultsTumor diameter (< 2 cm), BED10 (≥ 48Gy) and LMR (≥ 4) were found to be independently associated with good intracranial local control survival (i-LCS) through multivariate analysis. The median i-LCS was longer in patients with 2 independent risk factors (tumor diameter ≥ 2 and LMR < 4) administered with BED10 > 53.6Gy compared with patients administered with BED10 ≤ 53.6Gy (20.7 months vs 12.0 months, P = 0.042). LMR ≥ 4 (P = 0.019) and positivity for driver gene mutations (P = 0.011) were independently associated with better overall survival (OS).ConclusionsLMR is an independent prognostic factor of i-LCS and OS in NSCLC patients with brain oligo-metastasis treated with FSRT. Patients with tumor diameter ≥ 2 and LMR < 4 should be treated with BED10 greater than 53.6Gy.

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Section: Introductionmentioning

confidence: 99%

Pretreatment lymphocyte-to-monocyte ratio as a prognostic factor and influence on dose-effect in fractionated stereotactic radiotherapy for oligometastatic brain metastases in non-small cell lung cancer patients

et al. 2023

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Mortality After Stereotactic Radiosurgery for Brain Metastases and Implications for Optimal Utilization

Rydzewski¹,

Khan

Strauss

et al. 2018

American Journal of Clinical Oncology

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Analysis of short-term mortality after treatment for brain metastases by using the National Cancer Database provides a window into national treatment patterns and associated outcomes. Roughly 1 in 5 patients who receive SRS and roughly 1 in 3 patients 70 and older who receive SRS die within 90 days of treatment. These data suggest some degree of overutilization of SRS in some patient populations, most notably those patients over the age of 70.

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Management of Recurrent Brain Metastasis after Radiosurgery

Stockham

Suh²,

Chao³

et al. 2012

Progress in Neurological Surgery

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Stereotactic radiosurgery (SRS) has become a first-line treatment option for brain metastases, both as a boost following whole-brain radiation therapy (WBRT), and as stand-alone treatment. When SRS is used as a single modality treatment, the local and distant brain recurrence rates range from 73 to 76.4%. When used in combination with WBRT, recurrence rates range from 27 to 46.8%. As systemic therapies improve, the number of patients who develop new or recurrent brain metastases after SRS is likely to increase. The evidence regarding the safety and efficacy of salvage therapies is very limited, making options for treatment unclear and controversial. In this report, we review current diagnostic challenges regarding local recurrence after SRS and the development of new brain metastases after SRS. Potential therapeutic strategies and the patients for who each is recommended are discussed, including repeat SRS, surgical resection, WBRT, fractionated stereotactic radiosurgery, chemotherapy, and supportive care.

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Evaluation of Different Score Index for Predicting Prognosis in Gamma Knife Radiosurgical Treatment for Brain Metastasis

Cited by 6 publications

References 50 publications

Pretreatment lymphocyte-to-monocyte ratio as a prognostic factor and influence on dose-effect in fractionated stereotactic radiotherapy for oligometastatic brain metastases in non-small cell lung cancer patients

Pretreatment lymphocyte-to-monocyte ratio as a prognostic factor and influence on dose-effect in fractionated stereotactic radiotherapy for oligometastatic brain metastases in non-small cell lung cancer patients

Mortality After Stereotactic Radiosurgery for Brain Metastases and Implications for Optimal Utilization

Management of Recurrent Brain Metastasis after Radiosurgery

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