Stereotactic Radiosurgery for Poor Performance Status Patients

Kubicek, Gregory J.; Turtz, Alan; Xue, Jiangyu; Patel, Ashish; Richards, Gregory M.; LaCouture, Tamara; Cappelli, Louis; Diestelkamp, Tim; Saraiya, Piya V.; Bexon, Anne; Lerman, Nati; Goldman, Howard

doi:10.1016/j.ijrobp.2016.02.041

Cited by 16 publications

(12 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To the Editor: We thank the readers for their interest in our article (1,2) and completely agree that, although thought-provoking, our results warrant further study. Ideally, further research into stereotactic radiosurgery (SRS) for poor performance status (PS) would take form as a prospective single-arm study in which additional information could be collected (such as gait speed), to create a "frailty index" to determine poor PS patients in whom observation (best supportive care) would be the best option.…”

Section: In Reply To Alongi and Fiorentinosupporting

confidence: 63%

“…Strong coordination, interaction, and collaboration among all professional figures are also necessary to guarantee the most appropriate oncologic approach (2,3). Several experiences are revealing that the site where patients receive cancer care has implications for patients' outcomes (2,4).…”

Section: Multidisciplinary Approach To Improving the Value Of Radiatimentioning

confidence: 99%

“…Several experiences are revealing that the site where patients receive cancer care has implications for patients' outcomes (2,4). In fact, as reported by Jang et al (2), in prostate cancer patients who were evaluated solely by urologists, prostatectomy was the most proposed treatment, whereas among cases evaluated in a multidisciplinary setting, radiation therapy was the predominant treatment. Hospitals may play an impact in cancer management, and…”

Section: Multidisciplinary Approach To Improving the Value Of Radiatimentioning

confidence: 99%

See 2 more Smart Citations

In Reply to Alongi and Fiorentino

Kubicek

Goldman

2016

International Journal of Radiation Oncology*Biology*Physics

Self Cite

View full text Add to dashboard Cite

Section: In Reply To Alongi and Fiorentinosupporting

confidence: 63%

Section: Multidisciplinary Approach To Improving the Value Of Radiatimentioning

confidence: 99%

Section: Multidisciplinary Approach To Improving the Value Of Radiatimentioning

confidence: 99%

See 1 more Smart Citation

In Reply to Alongi and Fiorentino

Kubicek

Goldman

2016

International Journal of Radiation Oncology*Biology*Physics

Self Cite

View full text Add to dashboard Cite

“…Particularly RPA class III patients were excluded from most randomized studies because of their extremely poor prognosis [22,23]. However, in the modern treatment era, when chemotherapeutic agents with acceptable toxicity and advanced supportive management are introduced, lung cancer patients with brain metastases not necessarily have lower survival rates due to old age or poor performance [24,25].…”

Section: Discussionmentioning

confidence: 99%

“…One retrospective study has shown that RPA class III patients with brain metastases have a reasonable median OS of 7.2 months when they are treated with SRS alone [25]. That study also argues that poor performance patients may be ideal candidates for SRS because low incidence of distant CNS failure during life expectancy and single faction treatment can be helpful for patients with debility and their caregivers [25].…”

Section: Discussionmentioning

confidence: 99%

Stereotactic Radiosurgery for Recursive Partitioning Analysis Class II / III Lung Cancer Patients with Brain Metastases in the Modern Treatment Era

Ha¹,

Song²,

Jeong³

et al. 2018

Preprint

View full text Add to dashboard Cite

Stereotactic radiosurgery (SRS) is considered the initial treatment for lung cancer patients with small-sized and limited number of brain metastases. The objective of this study was to assess clinical outcomes of SRS treatment using CyberKnife (CK) for recursive partitioning analysis (RPA) class II/III patients with one to three brain metastases from lung cancer and identify which patients in the high RPA class could benefit from SRS. A total of 48 lung cancer patients who received CK-based SRS for their metastatic brain lesions from 2010 to 2017 were retrospectively analyzed. Radiographic response was evaluated during follow-up period. Overall survival (OS) and intracranial progression-free survival (IPFS) were calculated and prognostic variables associated with OS and IPFS were evaluated. Median follow-up time was 6.6 months. Local control rates at 6 months and 1-year following SRS were 98% and 92%, respectively. The median OS of all patients was 8 months. One-year and 2-year OS rates were 40.8% and 20.9%, respectively. In multivariate analysis, uncontrolled primary disease (p = 0.008) and ECOG performance status of 2 or 3 (p = 0.001) were independent prognostic factors for inferior OS. These two factors were also significantly associated with inferior IPFS. In subgroup analysis according to RPA class, primary disease status was the only prognostic factor, showing statistically significant OS differences in both RPA class II and III (controlled vs. uncontrolled: 41.1 vs. 12.3 months in RPA class II, p = 0.031; 26.9 vs. 4.1 months in RPA class III, p = 0.011). Our results indicated that SRS could be an effective treatment option for RPA class II/III patients with brain metastases from lung cancer in the modern treatment era. SRS might be particularly considered for patients with controlled primary disease.

show abstract