Predictive factors of early distant brain failure after gamma knife radiosurgery alone in patients with brain metastases of non-small-cell lung cancer

2017 ◽  
Vol 132 (2) ◽  
pp. 333-340 ◽  
Author(s):  
Young Cheol Na ◽  
Hyun Ho Jung ◽  
Hye Ryun Kim ◽  
Byoung Chul Cho ◽  
Jin Woo Chang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Gamma Knife ◽  
Predictive Factors ◽  
Gamma Knife Radiosurgery ◽  
Small Cell ◽  
Small Cell Lung ◽  
Brain Failure ◽  
Distant Brain Failure

scholarly journals Role of Gamma Knife Radiosurgery in Small Cell Lung Cancer: A Multi-Institutional Retrospective Study of the International Radiosurgery Research Foundation (IRRF)

Neurosurgery ◽  
2019 ◽  
Vol 87 (4) ◽  
pp. 664-671 ◽  
Author(s):  
Christopher P Cifarelli ◽  
John A Vargo ◽  
Wei Fang ◽  
Roman Liscak ◽  
Khumar Guseynova ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Gamma Knife ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Local Failure ◽  
Small Cell Lung ◽  
Brain Failure ◽  
Distant Brain Failure

Abstract BACKGROUND Despite a high incidence of brain metastases in patients with small-cell lung cancer (SCLC), limited data exist on the use of stereotactic radiosurgery (SRS), specifically Gamma Knife™ radiosurgery (Elekta AB), for SCLC brain metastases. OBJECTIVE To provide a detailed analysis of SCLC patients treated with SRS, focusing on local failure, distant brain failure, and overall survival (OS). METHODS A multi-institutional retrospective review was performed on 293 patients undergoing SRS for SCLC brain metastases at 10 medical centers from 1991 to 2017. Data collection was performed according to individual institutional review boards, and analyses were performed using binary logistic regression, Cox-proportional hazard models, Kaplan-Meier survival analysis, and competing risks analysis. RESULTS Two hundred thirty-two (79%) patients received SRS as salvage following prior whole-brain irradiation (WBRT) or prophylactic cranial irradiation, with a median marginal dose of 18 Gy. At median follow-up after SRS of 6.4 and 18.0 mo for surviving patients, the 1-yr local failure, distant brain failure, and OS were 31%, 49%, and 28%. The interval between WBRT and SRS was predictive of improved OS for patients receiving SRS more than 1 yr after initial treatment (21%, <1 yr vs 36%, >1 yr, P = .01). On multivariate analysis, older age was the only significant predictor for OS (hazard ratio 1.63, 95% CI 1.16-2.29, P = .005). CONCLUSION SRS plays an important role in the management of brain metastases from SCLC, especially in salvage therapy following WBRT. Ongoing prospective trials will better assess the value of radiosurgery in the primary management of SCLC brain metastases and potentially challenge the standard application of WBRT in SCLC patients.

scholarly journals Prognosis of Non-Small Cell Lung Cancer with Synchronous Brain Metastases Treated with Gamma Knife Radiosurgery

2006 ◽  
Vol 21 (3) ◽  
pp. 527 ◽  
Author(s):  
Doo-Sik Kong ◽  
Jung-Il Lee ◽  
Do Hyun Nam ◽  
Kwan Park ◽  
Jong Hyun Kim ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Gamma Knife ◽  
Cell Lung Cancer ◽  
Gamma Knife Radiosurgery ◽  
Small Cell ◽  
Small Cell Lung

scholarly journals Gamma Knife Radiosurgery for Brain Metastases in Non-Small Cell Lung Cancer Patients Treated with Immunotherapy or Targeted Therapy

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3668
Author(s):  
Anna Cho ◽  
Helena Untersteiner ◽  
Dorian Hirschmann ◽  
Abdallah Shaltout ◽  
Philipp Göbl ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Targeted Therapy ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Gamma Knife ◽  
Cell Lung Cancer ◽  
Combined Treatment ◽  
Gamma Knife Radiosurgery ◽  
Small Cell ◽  
Small Cell Lung

The combination of Gamma Knife radiosurgery (GKRS) and systemic immunotherapy (IT) or targeted therapy (TT) is a novel treatment method for brain metastases (BMs) in non-small cell lung cancer (NSCLC). To elucidate the safety and efficacy of concomitant IT or TT on the outcome after GKRS, 496 NSCLC patients with BMs, who were treated with GKRS were retrospectively reviewed. The median time between the initial lung cancer diagnosis and the diagnosis of brain metastases was one month. The survival after the initial BM diagnosis was significantly longer than the survival predicted by prognostic BM scores. After the first Gamma Knife radiosurgery treatment (GKRS1), the estimated median survival was 9.9 months (95% CI = 8.3–11.4). Patients with concurrent IT or TT presented with a significantly longer survival after GKRS1 than patients without IT or TT (p < 0.001). These significant differences in the survival were also apparent among the four treatment groups and remained significant after adjustment for Karnofsky performance status scale (KPS), recursive partitioning analysis (RPA) class, sex, and multiple BMs. About half of all our patients (46%) developed new distant BMs after GKRS1. Of note, no statistically significant differences in the occurrence of radiation reaction, radiation necrosis, or intralesional hemorrhage in association with IT or TT at or after GKRS1 were observed. In NSCLC-BM patients, the concomitant use of GKRS and IT or TT showed an increase in overall survival without increased complications related to GKRS. Therefore, the combined treatment with GKRS and IT or TT seems to be a safe and powerful treatment option and emphasizes the role of radiosurgery in modern BM treatment.

EP-1293 IMPACT OF TIME OF DAY OF GAMMA KNIFE RADIOSURGERY ON SURVIVAL FOR NON-SMALL CELL LUNG CANCER BRAIN METASTASES

2012 ◽  
Vol 103 ◽  
pp. S491-S492
Author(s):  
S.N. Badiyan ◽  
D.J. Ferraro ◽  
S. Yaddanapudi ◽  
R.E. Drzymala ◽  
A.Y. Lee ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Gamma Knife ◽  
Cell Lung Cancer ◽  
Gamma Knife Radiosurgery ◽  
Time Of Day ◽  
Small Cell ◽  
Small Cell Lung

scholarly journals RADI-07. GAMMA KNIFE RADIOSURGERY FOR SMALL CELL LUNG CANCER: PROGNOSTIC FACTORS INCLUDING ADDITIONAL LESIONS IDENTIFIED ON THE DAY OF RADIOSURGERY

2019 ◽  
Vol 1 (Supplement_1) ◽  
pp. i23-i23
Author(s):  
Kevin Chaung ◽  
Michael Kharouta ◽  
Stephen Shamp ◽  
Mitchell Machtay ◽  
Andrew Sloan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Gamma Knife ◽  
Cell Lung Cancer ◽  
Gamma Knife Radiosurgery ◽  
Small Cell ◽  
Initial Diagnosis ◽  
Small Cell Lung ◽  
Extracranial Metastases

Abstract OBJECTIVES: Prophylactic cranial irradiation (PCI) and whole brain radiation (WBRT) are standard of care for intracranial disease in small cell lung cancer (SCLC) patients. We sought to identify predictors of overall survival (OS) in SCLC patients treated with salvage Gamma Knife radiosurgery (GKRS) for brain metastases after prior WBRT or PCI. METHODS: Retrospective analyses were conducted on 26 SCLC patients treated with GKRS at one institution between May 2010 and June 2018. Factors predictive of OS were analyzed using Cox proportional hazards regression and Wilcoxon sum-rank testing. RESULTS: Median follow-up and median OS following GKRS was 6.6 mos (range 0.7–24.2 mos). Median OS was 21.4 mos from initial diagnosis (range 7.3–49.3 mos). Presence of extracranial metastases at the time of GKRS was not significantly associated with median OS after GKRS (5.8 mos for patients with extracranial metastases vs 7.2 mos for patients without, p=0.425). Mean number of lesions was 2.7 (range 1–10) on diagnostic brain MRIs and 4.1 (range 1–12) on GKRS planning MRIs. Eleven patients (42%) had the same number of lesions between diagnostic MRI and GKRS MRI, and 15 patients (58%) had additional lesions on the GKRS MRI. Number of lesions treated and total tumor volume were not associated with median OS. Patients who had additional lesions on GKRS MRI compared to diagnostic MRI had lower median OS from initial diagnosis of SCLC (29.9 mos vs 18.1 mos, p=0.0182) and a trend toward lower median OS from time of GKRS (7.3 mos vs 4.8 mos, p=0.0547) compared to patients who did not have additional lesions. CONCLUSIONS: Finding additional brain metastases on GKRS planning MRIs is associated with decreased OS in SCLC patients treated with salvage GKRS. Presence of extracranial metastases at the time of GKRS and number or total volume of brain metastases were not associated with OS.

scholarly journals P08.15 * RELEVANCE OF GAMMA KNIFE RADIOSURGERY ALONE FOR THE TREATMENT OF NON-SMALL CELL LUNG CANCER BRAIN METASTASES

2014 ◽  
Vol 16 (suppl 2) ◽  
pp. ii53-ii53
Author(s):  
F. Zairi ◽  
E. Le Rhun ◽  
Y. Ouammou ◽  
R. Aboukais ◽  
M. Vermandel ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Gamma Knife ◽  
Cell Lung Cancer ◽  
Gamma Knife Radiosurgery ◽  
Small Cell ◽  
Small Cell Lung
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