BACKGROUND: Patients with small-cell lung cancer have a high likelihood of developing brain metastases. Many of these patients will have prophylactic cranial irradiation (PCI) or eventually undergo whole brain radiation therapy (WBRT). Despite these treatments, a large number of these patients will have progression of their intracranial disease and require additional local therapy. Stereotactic radiosurgery (SRS) is an important treatment option for such patients. METHODS: We retrospectively reviewed the charts of 44 patients with brain metastases from small-cell lung cancer treated with gamma knife SRS. Multivariate analysis was used to determine significant prognostic factors influencing survival. RESULTS: The median follow-up from SRS in this patient population was 9 months (1-49 months). The median overall survival (OS) was 9 months after SRS. Karnofsky performance status (KPS) and combined treatment involving WBRT and SRS within 4 weeks were the two factors identified as being significant predictors of increased OS (p = 0.033 and 0.040, respectively). When comparing all patients, patients treated with a combined approach had a median OS of 14 months compared to 6 months if SRS was delivered alone. We also compared the OS times from the first definitive radiation: WBRT, WBRT and SRS if combined therapy was used, and SRS if the patient never received WBRT. The median survival for those groups was 12, 14, and 13 months, respectively, p = 0.19. Seventy percent of patients had follow-up magnetic resonance imaging available for review. Actuarial local control at 6 months and 12 months was 90% and 86%, respectively. Only 1 patient (2.2%) had symptomatic intracranial swelling related to treatment, which responded to a short course of steroids. New brain metastases outside of the treated area developed in 61% of patients at a median time of 7 months; 81% of these patients had received previous WBRT. CONCLUSIONS: Stereotactic radiosurgery for small-cell lung carcinoma brain metastases provided safe and effective local tumor control in the majority of patients.
BACKGROUND:Patients with small-cell lung cancer have a high likelihood of developing brain metastases. Many of these patients will have prophylactic cranial irradiation (PCI) or eventually undergo whole brain radiation therapy (WBRT). Despite these treatments, a large number of these patients will have progression of their intracranial disease and require additional local therapy. Stereotactic radiosurgery (SRS) is an important treatment option for such patients. METHODS: We retrospectively reviewed the charts of 44 patients with brain metastases from small-cell lung cancer treated with gamma knife SRS. Multivariate analysis was used to determine significant prognostic factors influencing survival. RESULTS: The median follow-up from SRS in this patient population was 9 months (1-49 months). The median overall survival (OS) was 9 months after SRS. Karnofsky performance status (KPS) and combined treatment involving WBRT and SRS within 4 weeks were the two factors identified as being significant predictors of increased OS (p = 0.033 and 0.040, respectively). When comparing all patients, patients treated with a combined approach had a median OS of 14 months compared to 6 months if SRS was delivered alone. We also compared the OS times from the first definitive radiation: WBRT, WBRT and SRS if combined therapy was used, and SRS if the patient never received WBRT. The median survival for those groups was 12, 14, and 13 months, respectively, p = 0.19. Seventy percent of patients had follow-up magnetic resonance imaging available for review. Actuarial local control at 6 months and 12 months was 90% and 86%, respectively. Only 1 patient (2.2%) had symptomatic intracranial swelling related to treatment, which responded to a short course of steroids. New brain metastases outside of the treated area developed in 61% of patients at a median time of 7 months; 81% of these patients had received previous WBRT. CONCLUSIONS: Stereotactic radiosurgery for small-cell lung carcinoma brain metastases provided safe and effective local tumor control in the majority of patients.
Authors: Sunit Harris; Michael D Chan; James F Lovato; Thomas L Ellis; Stephen B Tatter; J Daniel Bourland; Michael T Munley; Allan F deGuzman; Edward G Shaw; James J Urbanic; Kevin P McMullen Journal: Int J Radiat Oncol Biol Phys Date: 2012-02-17 Impact factor: 7.038
Authors: Christopher P Cifarelli; John A Vargo; Wei Fang; Roman Liscak; Khumar Guseynova; Ronald E Warnick; Cheng-Chia Lee; Huai-Che Yang; Hamid Borghei-Razavi; Tonmoy Maiti; Zaid A Siddiqui; Justin C Yuan; Inga S Grills; David Mathieu; Charles J Touchette; Diogo Cordeiro; Veronica Chiang; Judith Hess; Christopher J Tien; Andrew Faramand; Hideyuki Kano; Gene H Barnett; Jason P Sheehan; L Dade Lunsford Journal: Neurosurgery Date: 2020-09-15 Impact factor: 4.654
Authors: A Serna; P P Escolar; V Puchades; F Mata; D Ramos; M A Gómez; A Iglesias; J Salinas; M Alcaraz Journal: Clin Transl Oncol Date: 2015-03-17 Impact factor: 3.405
Authors: Joseph A Miccio; Andrew Barsky; Sarah Gao; Vivek Verma; Sonal S Noticewala; Vikram Jairam; Skyler B Johnson; James B Yu; James E Hansen; Sanjay Aneja; Yi An; Roy H Decker; S Bulent Omay; Jing Li; Goldie A Kurtz; Michelle Alonso-Basanta; John Y K Lee; Veronica L Chiang; Henry S Park Journal: J Radiosurg SBRT Date: 2020
Authors: J Griff Kuremsky; James J Urbanic; W Jeff Petty; James F Lovato; J Daniel Bourland; Stephen B Tatter; Thomas L Ellis; Kevin P McMullen; Edward G Shaw; Michael D Chan Journal: Neurosurgery Date: 2013-10 Impact factor: 4.654
Authors: Chad G Rusthoven; Masaaki Yamamoto; Denise Bernhardt; Derek E Smith; Dexiang Gao; Toru Serizawa; Shoji Yomo; Hitoshi Aiyama; Yoshinori Higuchi; Takashi Shuto; Atsuya Akabane; Yasunori Sato; Ajay Niranjan; Andrew M Faramand; L Dade Lunsford; James McInerney; Leonard C Tuanquin; Brad E Zacharia; Veronica Chiang; Charu Singh; James B Yu; Steve Braunstein; David Mathieu; Charles J Touchette; Cheng-Chia Lee; Huai-Che Yang; Ayal A Aizer; Daniel N Cagney; Michael D Chan; Douglas Kondziolka; Kenneth Bernstein; Joshua S Silverman; Inga S Grills; Zaid A Siddiqui; Justin C Yuan; Jason P Sheehan; Diogo Cordeiro; Kename Nosaki; Takahashi Seto; Christopher P Deibert; Vivek Verma; Samuel Day; Lia M Halasz; Ronald E Warnick; Daniel M Trifiletti; Joshua D Palmer; Albert Attia; Benjamin Li; Christopher P Cifarelli; Paul D Brown; John A Vargo; Stephanie E Combs; Kerstin A Kessel; Stefan Rieken; Samir Patel; Matthias Guckenberger; Nicolaus Andratschke; Brian D Kavanagh; Tyler P Robin Journal: JAMA Oncol Date: 2020-07-01 Impact factor: 31.777