scholarly journals CMET-14. DISTANT BRAIN FAILURE FOLLOWING STEREOTACTIC RADIOSURGERY FOR BRAIN METASTASES FROM NON-SMALL CELL LUNG CANCER

2018 ◽  
Vol 20 (suppl_6) ◽  
pp. vi56-vi56
Author(s):  
Andrew Keller ◽  
Sean All ◽  
Hanisha Patel ◽  
Steven Nguyen ◽  
Luke Pearson ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Stereotactic Radiosurgery ◽  
Cell Lung Cancer ◽  
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.

Care Patterns for Stereotactic Radiosurgery in Small Cell Lung Cancer Brain Metastases

2021 ◽  
Author(s):  
Olsi Gjyshi ◽  
Steven H. Lin ◽  
Todd A. Pezzi ◽  
Matthew S. Ning ◽  
Junsheng Ma ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Stereotactic Radiosurgery ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Care Patterns

scholarly journals P2.12-14 Stereotactic Radiosurgery for Brain Metastases in Small Cell Lung Cancer.

2018 ◽  
Vol 13 (10) ◽  
pp. S796
Author(s):  
E. Dudnik ◽  
S. Yust-Katz ◽  
N. Michaeli ◽  
T. Shochat ◽  
N. Peled ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Stereotactic Radiosurgery ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung

scholarly journals Benefit of dosimetry distribution for patients with multiple brain metastases from non-small cell lung cancer by a Cyberknife stereotactic radiosurgery (SRS) system

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xuyao Yu ◽  
Yuwen Wang ◽  
Zhiyong Yuan ◽  
Hui Yu ◽  
Yongchun Song ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Stereotactic Radiosurgery ◽  
Cell Lung Cancer ◽  
Treatment Time ◽  
Small Cell ◽  
Small Cell Lung ◽  
Prescription Dose ◽  
Single Lesion

Abstract Background In order to obtain a high dose conformal index of tumor and steep dose fall-off in healthy tissues for brain metastasis stereotactic radiosurgery (SRS), the aim of this study was to investigate SRS planning optimization by comparing one multiple-lesions plan (MLP) with multiple single-lesion plans (SLPs) for patients with multiple brain metastases using the Cyberknife (CK) system. Methods Fifty non-small cell lung cancer (NSCLC) patients (28 males and 22 females) with 2–4 brain metastases, inter-tumour distances less than 3 cm, were retrospectively replanned with the original prescription dose (12–32 Gy) in the original fractions (1–3). Two different clinical CK SRS plans (SLPs and MLP) were generated for the same patients with the same collimator and prescription isodose line (62–68%) by the CK Multiplan System. Both SLPs and MLP were able to achieve > 95% PTV volume covered prescription dose and met the Timmerman 2011 organs at risk (brainstem, optic nerve and pituitary) constraints. Results Compared with those in the SLPs, the maximum dose (Dmax) and mean dose (Dmean) of brainstem in the MLP were reduced 0.22–3.13% (2.62%) and 2.71–12.56% (5.57%), respectively, all P < 0.05. Meanwhile, the volumes of the whole brain minus the tumors that received a single dose equivalent of 8–16 Gy (V8Gy-V16Gy) were effectively reduced in the MLP. The treatment time parameters, the total number of beams and monitor units, of the MLP were reduced by 3.31 and 1.47% (P < 0.05), respectively. Although there were a few differences in the conformity index (CI) and homogeneity index (HI) between the two treatment plans, the differences were not statistically significant (P = 2.94 and 1.08 > 0.05). Conclusion One multiple-lesions plan for brain metastases could achieve higher precision in the target and lower doses in healthy tissue while shortening the treatment time and improving the treatment efficiency over multiple single-lesion plans.

Stereotactic Radiosurgery as Salvage for Brain Metastases From Small Cell Lung Cancer

2012 ◽  
Vol 84 (3) ◽  
pp. S293
Author(s):  
P. Rava ◽  
K.L. Leonard ◽  
S. Sioshansi ◽  
T.A. DiPetrillo ◽  
C.S. Melhus ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Stereotactic Radiosurgery ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung

scholarly journals Benefit of dosimetry distribution for patients with brain metastases from non-small cell lung cancer by Cyberknife Stereotactic radiosurgery (SRS) system

2020 ◽  
Author(s):  
Xuyao YU ◽  
Yuwen Wang ◽  
Zhiyong Yuan ◽  
Hui Yu ◽  
Yongchun Song ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Stereotactic Radiosurgery ◽  
Cell Lung Cancer ◽  
Treatment Time ◽  
Small Cell ◽  
Small Cell Lung ◽  
Multiple Lesions ◽  
Prescription Isodose

Abstract BackgroundTo pursue high precision in tumor and steeper dose fall-off in healthy tissues of brain metastases stereotactic radiosurgery (SRS), this study investigated an opitimized planning by comparison only one multiple-lesions-plan (MLP) and multiple single-lesion-plans (SLP) in the treatment of brain metastases using Cyberknife (CK) Robotic Radiosurgery System. MethodsFifty non-small cell lung cancer (NSCLC) patients (28 males and 22 females) with 2-4 multiple brain metastases were retrospectively replanned with 12 to 32 Gy prescription dose in 1 to 3 fractions. Two different clinical SRS plans (SLP and MLP) for the same patients were generated, under the same collimator and prescription isodose line (62-68%) by CK Multiplan System. Both the SLP and MLP were able to get ＞95% PTV volume covered prescription isodose and meet the Timmerman 2011 OAR (brainstem, optic nerve and pituitary) constraints.ResultsCompared with the SLP, the maximum dose (Dmax) and mean dose (Dmean) of brainstem in the MLP decreased 0.22-3.13% (2.62%) and 2.71-12.56% (5.57%), over all P＜0.05. While the volumes of whole brain minus the tumors received a single dose equivalence of 8-16Gy (V8Gy-V16Gy) could effectively reduce in the MLP. And the treatment time parameters (the total number of beams and monitor units (MU)) of the MLP declined 3.31% and 1.47% (P＜0.05) respectively. Although there were a few differences of conformity index (CI) and homogeneity index (HI) between two treatment plans, it was no statistical significance (P = 2.94 and 1.08＞ 0.05). ConclusionOne multiple-lesions-plan for brain metastases could achieve higher precision in target and lower dose in healthy tissue, while shorten the treatment time and improve the treatment efficiency.

scholarly journals MLTI-02. Impact of driver mutations on timing, pattern, treatment, and outcome in patients with brain metastases from non-small cell lung cancer

2021 ◽  
Vol 3 (Supplement_3) ◽  
pp. iii13-iii13
Author(s):  
Stephanie Jünger ◽  
Marie-Lisa Eich ◽  
Anna-Katharina Meissner ◽  
Maximilian Ruge ◽  
Roland Goldbrunner ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Stereotactic Radiosurgery ◽  
Cell Lung Cancer ◽  
Systemic Treatment ◽  
Small Cell ◽  
Driver Mutations ◽  
Small Cell Lung ◽  
Cerebral Control

Abstract Objective To assess the impact of driver mutations in non-small cell lung cancer (NSCLC) on the formation and treatment outcome of brain metastases (BM). Patients and methods We retrospectively analyzed patients with BM from NSCLC with respect to driver mutations and assessed timing and pattern of BM development as well as local cerebral control and survival after BM treatment. Results We included 253 patients. Histology was adenocarcinoma in 223, squamous cell carcinoma in 25 and not otherwise specified (NOS) in five patients. All tumors were analyzed for known alterations in NSCLC by panel sequencing and fluorescence in situ hybridization (FISH). An activating KRAS mutation (n=85) was the most prevalent mutation, followed by activating EGFR mutation (n=31) and MET amplification (n=29). Other mutations were detected in 27 patients. No alterations were found in 102 patients. Time to BM development did not differ between the molecular groups (p=.22), nor did the number (p=.72) or location (supra- vs. infratentorial; p=.76) of the BM. Patients underwent multimodal cerebral treatment comprising surgery followed by radiotherapy and/or stereotactic radiosurgery (n=138), whole brain radiotherapy (n=13) or stereotactic radiosurgery alone (n=102). Systemic treatment was initiated or continued after BM therapy in 169 patients and its frequency did not differ significantly between genotypes (p=.08) while the modality of medical treatment depended on genotype (p&lt;0.0001). The latter showed longer local cerebral control rates compared to other mutations (0.23) and a longer overall survival compared to KRAS and wild type genotypes (p=.015). Systemic treatment (HR 2.1 95%CI 1.4–3.0; p&lt;.0001) and a good clinical status (HR 2.1 95%CI 1.2–3.7; p=0.014) were the only independent factors for further survival. Conclusion The actual known driver mutations do not influence BM formation. Specific genotypes show a better oncological course, presumably due to available molecular treatment.

scholarly journals Benefit of dosimetry distribution for patients with multiple brain metastases from non-small cell lung cancer by Cyberknife Stereotactic radiosurgery (SRS) system

2020 ◽  
Author(s):  
Xuyao YU ◽  
Yuwen Wang ◽  
Zhiyong Yuan ◽  
Hui Yu ◽  
Yongchun Song ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Stereotactic Radiosurgery ◽  
Cell Lung Cancer ◽  
Treatment Time ◽  
Small Cell ◽  
Small Cell Lung ◽  
Prescription Dose ◽  
Single Lesion

Abstract Background: In order to obtain a high dose conformal index of tumor and steep dose fall-off in healthy tissues for brain metastasis stereotactic radiosurgery (SRS), the aim of this study was to investigate SRS planning optimization by comparing one multiple-lesions plan (MLP) with multiple single-lesion plans (SLPs) for patients with multiple brain metastases using the Cyberknife (CK) system.Methods: Fifty non-small cell lung cancer (NSCLC) patients (28 males and 22 females) with 2-4 brain metastases, inter-tumour distances less than 3 cm, were retrospectively replanned with the original prescription dose (12-32 Gy) in the original fractions (1-3). Two different clinical CK SRS plans (SLPs and MLP) were generated for the same patients with the same collimator and prescription isodose line (62-68%) by the CK Multiplan System. Both SLPs and MLP were able to achieve >95% PTV volume covered prescription dose and met the Timmerman 2011 organs at risk (brainstem, optic nerve and pituitary) constraints.Results: Compared with those in the SLPs, the maximum dose (Dmax) and mean dose (Dmean) of brainstem in the MLP were reduced 0.22-3.13% (2.62%) and 2.71-12.56% (5.57%), respectively, all P<0.05. Meanwhile, the volumes of the whole brain minus the tumors that received a single dose equivalent of 8-16 Gy (V8Gy-V16Gy) were effectively reduced in the MLP. The treatment time parameters, the total number of beams and monitor units, of the MLP were reduced by 3.31% and 1.47% (P<0.05), respectively. Although there were a few differences in the conformity index (CI) and homogeneity index (HI) between the two treatment plans, the differences were not statistically significant (P = 2.94 and 1.08>0.05).Conclusion: One multiple-lesions plan for brain metastases could achieve higher precision in the target and lower doses in healthy tissue while shortening the treatment time and improving the treatment efficiency over multiple single-lesion plans.

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