Outcome of Stereotactic Radiosurgery for Patients with Non-Small Cell Lung Cancer Metastatic to The Brain

Mariya, Yasushi; Sekizawa, G; Matsuoka, Yosuke; Seki, Hirobumi; Sugawara, Takayuki

doi:10.1269/jrr.90130

Cited by 33 publications

(49 citation statements)

References 31 publications

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“…These results are consistent with previously published studies. 24,30 There were multiple statistically significant factors that influenced survival, including sex, age, primary status, prior WBRT, KPS score, marginal dose, and tumor characteristics such as histology subtype, tumor volume, and number of metastases.…”

Section: Discussion Survivalmentioning

confidence: 99%

“…The local tumor control after SRS in NSCLC patients consistently exceeds 80% in the literature. 24,30 The utilization of SRS for NSCLC metastases has increased significantly and appropriately abbreviatioNs GKRS = Gamma Knife radiosurgery; KPS = Karnofsky Performance Scale; NSCLC = non-small cell lung cancer; RPA = recursive partitioning analysis; RTOG = Radiation Therapy Oncology Group; SRS = stereotactic radiosurgery; WBRT = whole-brain radiotherapy. obJect Non-small cell lung cancer (NSCLC) is the most frequent cancer that metastasizes to brain.…”

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confidence: 99%

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Gamma Knife radiosurgery for the management of cerebral metastases from non–small cell lung cancer

Bowden

Kano

Caparosa

et al. 2015

JNS

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L ung cancer is the most common malignancy in the world, accounting for 13% of all documented cancer cases, of which 85% are non-small cell lung cancer (NSCLC). NSCLC is often diagnosed at an advanced stage, as 56% of patients present with distant metastases. 31The 5-year survival for NSCLC is 19.3% overall but decreases to 4.1% with distant metastases. 15Intracranial metastases occur in an estimated 30%-40% of patients with NSCLC and are often identifiable at the time of primary diagnosis. 6,18,23 The presence of intracranial metastases is invariably associated with a decrease in median survival across all cancer types. 10 The median survival for a patient with NSCLC and intracranial metastases who forgoes treatment is reportedly less than 2 months. The addition of fractionated whole-brain radiation therapy (WBRT) increases survival to only 3-6 months. 4,6 Gamma Knife radiosurgery (GKRS) has proven to be a low risk and effective treatment strategy for a wide variety of patients with brain metastases. The local tumor control after SRS in NSCLC patients consistently exceeds 80% in the literature. 24,30 The utilization of SRS for NSCLC metastases has increased significantly and appropriately abbreviatioNs GKRS = Gamma Knife radiosurgery; KPS = Karnofsky Performance Scale; NSCLC = non-small cell lung cancer; RPA = recursive partitioning analysis; RTOG = Radiation Therapy Oncology Group; SRS = stereotactic radiosurgery; WBRT = whole-brain radiotherapy. obJect Non-small cell lung cancer (NSCLC) is the most frequent cancer that metastasizes to brain. Stereotactic radiosurgery (SRS) has become the management of choice for most patients with such metastatic tumors. Therefore, the authors endeavored to elucidate the survival and SRS outcomes for patients with NSCLC metastasis at their center. methods In this single-institution retrospective analysis, the authors reviewed their experience with NSCLC metastasis during a 10-year period from 2001 to 2010. Seven hundred twenty patients underwent Gamma Knife radiosurgery. A total of 1004 SRS procedures were performed, and 3143 tumors were treated. The NSCLC subtype was adenocarcinoma in 386 patients, squamous cell carcinoma in 111 patients, and large cell carcinoma in 34 patients. The median aggregate tumor volume was 4.5 cm 3 (range 0.1-88 cm 3 ). results The median survival time after diagnosis of brain metastasis from NSCLC was 12.6 months, and the median survival after SRS was 8.5 months. The 1-, 2-, and 5-year survival rates after SRS were 39%, 21%, and 10%, respectively. Postradiosurgery survival was decreased in patients treated with prior whole-brain radiation therapy compared with SRS alone (p = 0.003). Aggregate tumor volume was inversely related to survival after SRS (p < 0.001), and the histological subgroups demonstrated significant survival differences (p = 0.023). The overall local tumor control rate in the entire group was 92.8%. One hundred seventy-four patients (24%) underwent repeat SRS for new or resistant metastatic deposits. coNclusioNs Stereotactic radio...

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Section: Discussion Survivalmentioning

confidence: 99%

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confidence: 99%

Gamma Knife radiosurgery for the management of cerebral metastases from non–small cell lung cancer

Bowden

Kano

Caparosa

et al. 2015

JNS

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“…Rades et al concluded that performance status, age, and extracranial metastases have a potential effect on survival 13 . Mariya et al revealed that the factors significantly affecting overall survival were primary tumor control, performance status, and number of brain metastases 14 . Nieder et al 7 found that the only factors influencing survival were primary tumor control and performance status.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors and Scoring Systems for Non-Small Cell Lung Cancer Patients Harboring Brain Metastases Treated with Gamma Knife Radiosurgery

et al. 2012

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Background: The survival of non-small cell lung cancer (NSCLC) patients with brain metastases is reported to be 3∼6 months even with aggressive treatment. Some patients have very short survival after aggressive treatment and reliable prognostic scoring systems for patients with cancer have a strong correlation with outcome, often supporting decision making and treatment recommendations. Methods: A total of one hundred twenty two NSCLC patients with brain metastases who received gamma knife radiosurgery (GKRS) were analyzed. Survival analysis was calculated in all patients for thirteen available prognostic factors and four prognostic scoring systems: score index for radiosurgery (SIR), recursive partitioning analysis (RPA), graded prognostic assessment (GPA), and basic score for brain metastases (BSBM). Results: Age, Karnofsky performance status, largest brain lesion volume, systemic chemotherapy, primary tumor control, and medication of epidermal growth factor receptor tyrosine kinase inhibitor were statistically independent prognostic factors for survival. A multivariate model of SIR and RPA identified significant differences between each group of scores. We found that three-tiered indices such as SIR and RPA are more useful than four-tiered scoring systems (GPA and BSBM). Conclusion: There is little value of RPA class III (most unfavorable group) for the same results of 6-month and 1-year survival rate. Thus, SIR is the most useful index to sort out patients with poorer prognosis. Further prospective trials should be performed to develop a new molecular-and gene-based prognostic index model.

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“…Such limited metastases are referred to as oligometastases. Local therapy, such as surgery and radiotherapy, has been applied successfully in appropriately selected patients, especially for patients with either brain metastasis alone or those with adrenal metastasis alone [31][32][33][34] . Recently, Yano et al reported a retrospective study reviewing their therapeutic experience with postoperatively recurrent NSCLC patients and demonstrated that a histology of adenocarcinoma, a longer disease-free interval (≥ 1 year) and the use of local therapy are significantly preferable prognostic factors for the postrecurrence OS of patients with distant metastasis alone [6] .…”

Section: Treatment Of Oligometastatic Recurrencementioning

confidence: 99%

Therapeutic strategy for postoperative recurrence in patients with non-small cell lung cancer

Yano

Okamoto

Fukuyama

et al. 2014

WJCO

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Core tip: The postrecurrence survival in non-small cell lung cancer (NSCLC) is considered to largely depend on both the mode of first recurrence (distant, locoregional or combined) and the treatment modality. Therefore, the therapeutic strategy for treating postoperative recurrence in patients with NSCLC should be considered according to the mode of first recurrence. In this way, proper treatment specific to the mode of recurrence will be developed and improvements of the postrecurrence survival can be obtained.Yano T, Okamoto T, Fukuyama S, Maehara Y. Therapeutic strategy for postoperative recurrence in patients with non-small cell lung cancer.

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Outcome of Stereotactic Radiosurgery for Patients with Non-Small Cell Lung Cancer Metastatic to The Brain

Cited by 33 publications

References 31 publications

Gamma Knife radiosurgery for the management of cerebral metastases from non–small cell lung cancer

Gamma Knife radiosurgery for the management of cerebral metastases from non–small cell lung cancer

Prognostic Factors and Scoring Systems for Non-Small Cell Lung Cancer Patients Harboring Brain Metastases Treated with Gamma Knife Radiosurgery

Therapeutic strategy for postoperative recurrence in patients with non-small cell lung cancer

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