The epidemiology of primary and metastatic brain tumors in infancy through childhood

Object. The purpose of this retrospective study was to evaluate the effectiveness of gamma knife radiosurgery (GKS) for the treatment of metastatic brain tumors from lung cancer, with particular reference to small cell lung carcinoma (SCLC) compared with non-SCLC (NSCLC). Methods. Two hundred forty-five consecutive patients meeting the following five criteria were evaluated in this study: 1) no prior brain tumor treatment; 2) 25 or fewer lesions; 3) a maximum of three tumors with a diameter of 20 mm or larger; 4) no surgically inaccessible tumor 30 mm or greater in diameter; and 5) more than 3 months of life expectancy. According to the same treatment protocol, large tumors (≥ 30 mm) were surgically removed and the other small lesions (< 30 mm) were treated with GKS. New lesions were treated with repeated GKS. Chemotherapy was administered, according to the primary physician's protocol, as aggressively as possible. Progression-free, overall, neurological, qualitative, and new lesion—free survival were calculated with the Kaplan—Meier method and were compared in the SCLC and NSCLC groups by using the log-rank test. The poor prognostic factors for each type of survival were also analyzed with the Cox proportional hazard model. Conclusions. Tumor control rate at 1 year was 94.5% in the SCLC group and 98% in the NSCLC group. The median survival time was 9.1 months in the SCLC group and 8.6 months in the NSCLC group. The 1-year survival rates in the SCLC group were 86.5% for neurological survival and 68.9% for qualitative survival; those in the NSCLC group were 87.9% for neurological and 78.9% for qualitative survival. The estimated median interval to emergence of a new lesion was 6.9 months in the SCLC group and 9.8 months in the NSCLC group. There was no significant difference between the two groups for any type of survival; this finding was verified by multivariate analysis. The results of this study suggest that GKS appears to be as effective in treating brain metastases from SCLC as for those from NSCLC.

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Does gamma knife surgery stimulate cellular immune response to metastatic brain tumors? A histopathological and immunohistochemical study

Journal of Neurosurgery ◽

10.3171/sup.2005.102.s_supplement.0180 ◽

2005 ◽

Vol 102 (Special_Supplement) ◽

pp. 180-184 ◽

Cited By ~ 3

Author(s):

György T. Szeifert ◽

Isabelle Salmon ◽

Sandrine Rorive ◽

Nicolas Massager ◽

Daniel Devriendt ◽

...

Keyword(s):

Immune Response ◽

Brain Tumors ◽

Gamma Knife ◽

Cellular Immune Response ◽

Lymphocytic Infiltration ◽

Gamma Knife Surgery ◽

Metastatic Brain Tumors ◽

Content Type ◽

Cellular Immune ◽

Fine Print

Object. The aim of this study was to analyze the cellular immune response and histopathological changes in secondary brain tumors after gamma knife surgery (GKS). Methods. Two hundred ten patients with cerebral metastases underwent GKS. Seven patients underwent subsequent craniotomy for tumor removal between 1 and 33 months after GKS. Four of these patients had one tumor, two patients had two tumors, and one patient had three. Histological and immunohistochemical investigations were performed. In addition to routine H & E and Mallory trichrome staining, immunohistochemical reactions were conducted to characterize the phenotypic nature of the cell population contributing to the tissue immune response to neoplastic deposits after radiosurgery. Light microscopy revealed an intensive lymphocytic infiltration in the parenchyma and stroma of tumor samples obtained in patients in whom surgery was performed over 6 months after GKS. Contrary to this, extensive areas of tissue necrosis with either an absent or scanty lymphoid population were observed in the poorly controlled neoplastic specimens obtained in cases in which surgery was undertaken in patients less than 6 months after GKS. Immunohistochemical characterization demonstrated the predominance of CD3-positive T cells in the lymphoid infiltration. Conclusions. Histopathological findings of the present study are consistent with a cellular immune response of natural killer cells against metastatic brain tumors, presumably stimulated by the ionizing energy of focused radiation.

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MET-05 Clinical investigation of treatment results and recurrence patterns of metastatic brain tumors from the viewpoint of postoperative irradiation

Neuro-Oncology Advances ◽

10.1093/noajnl/vdaa143.083 ◽

2020 ◽

Vol 2 (Supplement_3) ◽

pp. ii19-ii19

Author(s):

Tetsuo Hashiba ◽

Haruka Kawano ◽

Katsuya Ueno ◽

Qiang Lee ◽

Haruna Isozaki ◽

...

Keyword(s):

Radiation Therapy ◽

Brain Tumors ◽

Clinical Investigation ◽

Postoperative Radiotherapy ◽

En Bloc Resection ◽

Metastatic Brain Tumors ◽

Treatment Results ◽

En Bloc ◽

Postoperative Radiation Therapy ◽

Observation Period

Abstract While whole brain radiation therapy (WBRT) had been the standard postoperative radiation therapy for metastatic brain tumors for long time, recently local radiation therapy (LRT) has be become to be a new standard due to the accumulation of clinical evidences. Treatment results and pattern of recurrence were retrospectively analyzed from view point of postoperative radiotherapy. In this study, totally 69 patients were included and they were divided into WBRT group or LRT group. We analyzed the number of lesions, treated era, overall survival after diagnosis of metastasis (OS), recurrence free survival after RT (RFS), and patterns of recurrences. The subjects consisted of 37males and 32 females and average age was 61.7 years old. There were 49 cases in the WBRT group and 20 cases in the LRT group. While all cases before November 2017 had WBRT performed, LRT was adopted mainly in cases with a small number of metastases since December 2017. Although there was a difference in the observation period between the two groups, OS tended to be longer in the LRT group (P=0.08), while RFS tended to be shorter in the LRT group (P=0.08). Radiological recurrence after RT was observed in 7 cases in both groups, and in WBRT group, all cases were local recurrence, whereas in LRT group, all cases were new lesions or disseminated recurrence. Although there are biases such as the difference in observation period between the two groups and the tendency to adopt WBRT in cases with a large number of metastases, there is a possibility that postoperative LRT is not inferior to WBRT, especially for cases with a small number of metastases. However, we have experienced some cases of disseminated recurrence, and so it is necessary to consider the resection fashion such as whether en-bloc resection or piece meal resection when selecting postoperative RT.

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Radiographic Features of Metastatic Brain Tumors from ALK-rearranged Non-small Cell Lung Cancer: Implications for Optimal Treatment Modalities

Journal of Cancer ◽

10.7150/jca.30091 ◽

2019 ◽

Vol 10 (26) ◽

pp. 6660-6665

Author(s):

Li Chu ◽

Jianjiao Ni ◽

Xi Yang ◽

Tong Tong ◽

Jialei Wang ◽

...

Keyword(s):

Lung Cancer ◽

Brain Tumors ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Optimal Treatment ◽

Treatment Modalities ◽

Metastatic Brain Tumors ◽

Small Cell Lung ◽

Radiographic Features

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Surgical management of brain metastases

Neurosurgical FOCUS ◽

10.3171/foc.2007.22.3.3 ◽

2007 ◽

Vol 22 (3) ◽

pp. 1-7 ◽

Cited By ~ 27

Author(s):

Moksha G. Ranasinghe ◽

Jonas M. Sheehan

Keyword(s):

Brain Tumors ◽

Systemic Disease ◽

Postoperative Management ◽

Study Data ◽

Preoperative Imaging ◽

Metastatic Brain Tumors ◽

Patients With Cancer ◽

Proper Patient Selection ◽

Positive Effect

✓Metastatic brain tumors continue to increase in incidence as patients with cancer live longer. The options for management continue to evolve as well, with advances in radiation-based treatment, chemotherapy, and surgery. Although metastatic brain tumors are frequently treated without surgical intervention, there continues to be a significant role for surgery in caring for patients with these lesions. Study data have proven that surgery has a positive effect on survival and quality of life in properly selected patients. Those with a suitable age, functional status, systemic disease control, and several metastases may be suitable for surgical treatment. Advances in preoperative imaging and planning as well as intraoperative surgical adjuncts have lowered the morbidity associated with resection. With proper patient selection and operative and postoperative management, resection continues to play a significant and evolving role in the care of patients with metastatic brain tumor.

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