Lung Carcinoma Metastatic in the Brain

2020 ◽  
Author(s):  
Keyword(s):  
Lung Carcinoma ◽  
The Brain

Radiosurgery for patients with recurrent small cell lung carcinoma metastatic to the brain: outcomes and prognostic factors

2005 ◽  
Vol 102 (Special_Supplement) ◽  
pp. 247-254 ◽  
Author(s):  
Jason Sheehan ◽  
Douglas Kondziolka ◽  
John Flickinger ◽  
L. Dade Lunsford
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Lung Carcinoma ◽  
Small Cell Lung Carcinoma ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Content Type ◽  
The Brain ◽  
Fine Print

Object. Lung carcinoma is the leading cause of death from cancer. More than 50% of those with small cell lung cancer develop a brain metastasis. Corticosteroid agents, radiotherapy, and resection have been the mainstays of treatment. Nonetheless, median survival for patients with small cell lung carcinoma metastasis is approximately 4 to 5 months after cranial irradiation. In this study the authors examine the efficacy of gamma knife surgery for treating recurrent small cell lung carcinoma metastases to the brain following tumor growth in patients who have previously undergone radiation therapy, and they evaluate factors affecting survival. Methods. A retrospective review of 27 patients (47 recurrent small cell lung cancer brain metastases) undergoing radiosurgery was performed. Clinical and radiographic data obtained during a 14-year treatment period were collected. Multivariate analysis was utilized to determine significant prognostic factors influencing survival. The overall median survival was 18 months after the diagnosis of brain metastases. In multivariate analysis, factors significantly affecting survival included: 1) tumor volume (p = 0.0042); 2) preoperative Karnofsky Performance Scale score (p = 0.0035); and 3) time between initial lung cancer diagnosis and development of brain metastasis (p = 0.0127). Postradiosurgical imaging of the brain metastases revealed that 62% decreased, 19% remained stable, and 19% eventually increased in size. One patient later underwent a craniotomy and tumor resection for a tumor refractory to radiosurgery and radiation therapy. In three patients new brain metastases were demonstrating on follow-up imaging. Conclusions. Stereotactic radiosurgery for recurrent small cell lung carcinoma metastases provided effective local tumor control in the majority of patients. Early detection of brain metastases, aggressive treatment of systemic disease, and a therapeutic strategy including radiosurgery can extend survival.

Radiosurgery for patients with recurrent small cell lung carcinoma metastatic to the brain: outcomes and prognostic factors

2005 ◽  
Vol 102 ◽  
pp. 247-254 ◽  
Author(s):  
Jason Sheehan ◽  
Douglas Kondziolka ◽  
John Flickinger ◽  
L. Dade Lunsford
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Lung Carcinoma ◽  
Small Cell Lung Carcinoma ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Content Type ◽  
The Brain ◽  
Fine Print

Object.Lung carcinoma is the leading cause of death from cancer. More than 50% of those with small cell lung cancer develop a brain metastasis. Corticosteroid agents, radiotherapy, and resection have been the mainstays of treatment. Nonetheless, median survival for patients with small cell lung carcinoma metastasis is approximately 4 to 5 months after cranial irradiation. In this study the authors examine the efficacy of gamma knife surgery for treating recurrent small cell lung carcinoma metastases to the brain following tumor growth in patients who have previously undergone radiation therapy, and they evaluate factors affecting survival.Methods.A retrospective review of 27 patients (47 recurrent small cell lung cancer brain metastases) undergoing radiosurgery was performed. Clinical and radiographic data obtained during a 14-year treatment period were collected. Multivariate analysis was utilized to determine significant prognostic factors influencing survival.The overall median survival was 18 months after the diagnosis of brain metastases. In multivariate analysis, factors significantly affecting survival included: 1) tumor volume (p = 0.0042); 2) preoperative Karnofsky Performance Scale score (p = 0.0035); and 3) time between initial lung cancer diagnosis and development of brain metastasis (p = 0.0127). Postradiosurgical imaging of the brain metastases revealed that 62% decreased, 19% remained stable, and 19% eventually increased in size. One patient later underwent a craniotomy and tumor resection for a tumor refractory to radiosurgery and radiation therapy. In three patients new brain metastases were demonstrating on follow-up imaging.Conclusions.Stereotactic radiosurgery for recurrent small cell lung carcinoma metastases provided effective local tumor control in the majority of patients. Early detection of brain metastases, aggressive treatment of systemic disease, and a therapeutic strategy including radiosurgery can extend survival.

scholarly journals BSCI-07. BONE MARROW T-CELL SEQUESTRATION IN THE SETTING OF BRAIN METASTASES

2019 ◽  
Vol 1 (Supplement_1) ◽  
pp. i2-i2
Author(s):  
Pakawat Chongsathidkiet ◽  
Karolina Woroniecka ◽  
Cosette Dechant ◽  
Hanna Kemeny ◽  
Xiuyu Cui ◽  
...  
Keyword(s):  
Bone Marrow ◽  
T Cells ◽  
T Cell ◽  
Breast Carcinoma ◽  
Brain Metastases ◽  
Lung Carcinoma ◽  
Immune Evasion ◽  
Intracranial Tumors ◽  
Cell Counts ◽  
The Brain

Abstract INTRODUCTION: Brain metastases remain one of the most dreaded consequences of late stage cancer, yet their incidence has risen as survival from primary cancers has improved. We have recently reported that tumors harbored within the brain, specifically, sequester T-cells within the bone marrow as a novel mechanism of immune evasion. Sequestration results from tumor-imposed loss of S1P1 receptor from the T-cell surface. Stabilization of the receptor on T-cells frees T-cells from sequestration and licenses T-cell activating therapies for intracranial tumors. While this phenomenon was initially uncovered in glioblastoma, its role in promoting immune-evasion in brain metastases remains less clear. METHODS: Blood, bone marrow, and tumors were collected from mice bearing intracranial tumors commonly metastatic to the brain, including lung carcinoma (LLC), melanoma (B16F10), or breast carcinoma (E0771) and analyzed by flow cytometry. T-cell S1P1 levels, as well as total T-cell counts were assessed in each compartment. Correlation analyses were conducted between T-cell counts and S1P1 levels on T-cells in the bone marrow across intracranial and subcutaneous murine tumor models. RESULTS: T-cell lymphopenia and accompanying accumulation of T-cells in the bone marrow were observed in the murine models of lung carcinoma, melanoma, and breast carcinoma, but only when these tumor lines were implanted intracranially. Sequestered T-cells in tumor-bearing mice showed decreased surface S1P1 levels in a manner correlating with their sequestration. CONCLUSION: S1P1-mediated bone marrow T-cell sequestration is a novel mode of cancer-induced T-cell dysfunction in intracranial tumors. Preventing receptor internalization abrogates T-cell sequestration and licenses T-cell activating therapies in glioblastoma. Sequestration is now observed in models of brain metastases. Pharmacologic strategies to stabilize S1P1, reverse sequestration, and restore circulating T-cell numbers are anticipated to improve immunotherapeutic efficacy for brain metastases.

scholarly journals High incidence of disease recurrence in the brain and leptomeninges in patients with nonsmall cell lung carcinoma after response to gefitinib

Cancer ◽  
2005 ◽  
Vol 103 (11) ◽  
pp. 2344-2348 ◽  
Author(s):  
Antonio M. P. Omuro ◽  
Mark G. Kris ◽  
Vincent A. Miller ◽  
Enrico Franceschi ◽  
Neelam Shah ◽  
...  
Keyword(s):  
Lung Carcinoma ◽  
Disease Recurrence ◽  
Cell Lung Carcinoma ◽  
Nonsmall Cell Lung Carcinoma ◽  
High Incidence ◽  
The Brain

Impact of aggressive therapy in patients with non-small cell lung carcinoma presenting with brain-only oligometastatic disease.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 8069-8069 ◽  
Author(s):  
Phillip J. Gray ◽  
David Sher ◽  
Beow Y. Yeap ◽  
Sarah K Cryer ◽  
Raymond H. Mak ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Lung Carcinoma ◽  
Small Cell Lung Carcinoma ◽  
Performance Status ◽  
Small Cell ◽  
Primary Site ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Aggressive Therapy ◽  
The Brain

8069 Background: Optimal therapy for patients with non-small cell lung carcinoma (NSCLC) presenting with synchronous brain metastases as their only metastatic site is not well defined. We investigated whether aggressive therapy directed to the primary site or whole-brain radiotherapy (WBRT) were associated with improved outcomes in this subset of patients. Methods: We conducted a retrospective analysis of patients seen at the Dana-Farber Cancer Institute between 1/2000 and 1/2011. Patients with NSCLC, 1-4 synchronous brain metastases and no other sites of metastatic disease confirmed by CT or PET scan were included. Patients with poor performance status were excluded. Aggressive thoracic therapy (ATT) was defined as surgical resection of the primary disease or radiotherapy to a dose of greater than 45 Gy. A Cox proportional hazards model was used to analyze effects on survival and a competing risks model was constructed to analyze the risk of recurrence in the brain. Results: 66 patients met the study criteria. Median follow-up for survivors was 32.3 months. Excluding the metastatic disease, 9 patients had stage I disease, 10 stage II and 47 stage III. 38 patients received ATT. Patients receiving ATT were significantly younger (median age 55 vs. 60.5 years) but otherwise had a similar distribution of sex, performance status and number of brain metastases. Receipt of ATT was associated with significantly prolonged overall survival (OS) (median 26.8 vs. 10.9 months; p<0.001). Actuarial 5-year survival was 28% for those who received ATT vs. 0%. ATT remained significantly associated with OS after controlling for age, stage, performance status and receipt of WBRT (HR 0.42, p=0.016). On multivariate analysis, receipt of ATT (HR 3.14, p=0.048) and WBRT (HR 0.10, p=0.005) were the only factors predictive of first failure in the brain. Receipt of initial WBRT did not improve OS. Conclusions: Patients with NSCLC presenting with synchronous brain-only metastases may still benefit from aggressive therapy directed to the thoracic primary site. Use of WBRT for this subgroup does not improve OS but significantly reduces future brain recurrences.

scholarly journals Stereotactic radiosurgery for patients with nonsmall cell lung carcinoma metastatic to the brain

Cancer ◽  
1997 ◽  
Vol 80 (11) ◽  
pp. 2075-2083 ◽  
Author(s):  
Young Soo Kim ◽  
Douglas Kondziolka ◽  
John C. Flickinger ◽  
L. Dade Lunsford
Keyword(s):  
Stereotactic Radiosurgery ◽  
Lung Carcinoma ◽  
Cell Lung Carcinoma ◽  
Nonsmall Cell Lung Carcinoma ◽  
The Brain

Gamma knife radiosurgery for metastatic disease to the brain from non-small cell lung carcinoma

1998 ◽  
Vol 42 (1) ◽  
pp. 262
Author(s):  
Sanjeev Aggarwal ◽  
John W. Ames ◽  
Pradip Amin ◽  
Allen T. Banegura ◽  
Charles A. Sansur ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Metastatic Disease ◽  
Lung Carcinoma ◽  
Small Cell Lung Carcinoma ◽  
Gamma Knife Radiosurgery ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
The Brain

scholarly journals Risk factors for brain metastases in surgically staged IIIA non-small cell lung cancer patients treated with surgery, radiotherapy and chemotherapy

2011 ◽  
Vol 68 (8) ◽  
pp. 643-649 ◽  
Author(s):  
Marina Petrovic ◽  
Nevenka Ilic ◽  
Olivera Loncarevic ◽  
Ivan Cekerevac ◽  
Zorica Lazic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Brain Metastases ◽  
Lung Carcinoma ◽  
Cell Lung Cancer ◽  
Preoperative Radiotherapy ◽  
Postoperative Radiotherapy ◽  
Nodal Status ◽  
Cell Lung Carcinoma ◽  
The Brain

Introduction/Aim. Lung cancer is a leading cause of mortality among patients with carcinomas. The aim of this study was to point out risk factors for brain metastases (BM) appearance in patients with IIIA (N2) stage of nonsmall cell lung cancer (NSCLC) treated with three-modal therapy. Methods. We analyzed data obtained from 107 patients with IIIA (N2) stage of NSCLC treated surgically with neoadjuvant therapy. The frequency of brain metastases was examined regarding age, sex, histological type and the size of tumor, nodal status, the sequence of radiotherapy and chemotherapy application and the type of chemotherapy. Results. Two and 3-year incidence rates of BM were 35% and 46%, respectively. Forty-six percent of the patients recurred in the brain as their first failure in the period of three years. Histologically, the patients with nonsquamous cell lung carcinoma had significantly higher frequency of metastases in the brain compared with the group of squamous cell lung carcinoma (46% : 30%; p = 0.021). Examining treatment-related parameters, treatment with taxane-platinum containing regimens was associated with a lower risk of brain metastases, than platinum-etoposide chemotherapy regimens (31% : 52%; p = 0.011). Preoperative radiotherapy, with or without postoperative treatment, showed lower rate of metastases in the brain compared with postoperative radiotherapy treatment only (33% : 48%; p = 0.035). Conclusion. Brain metastases are often site of recurrence in patients with NSCLC (IIIA-N2). Autonomous risk factors for brain metastases in this group of patients are non-squamous NSCLC, N1-N2 nodal status, postoperative radiotherapy without preoperative radiotherapy.

Toxic Epidermal Necrolysis of the Scalp following Anticonvulsant Use and Cranial Irradiation

2001 ◽  
Vol 5 (6) ◽  
pp. 475-478 ◽  
Author(s):  
Jennifer T. Trent ◽  
Leyda E. Bowes ◽  
Paolo Romanelli ◽  
Francisco A. Kerdel
Keyword(s):  
Glioblastoma Multiforme ◽  
Toxic Epidermal Necrolysis ◽  
Lung Carcinoma ◽  
Cranial Irradiation ◽  
Seizure Prophylaxis ◽  
Cranial Radiation ◽  
Increased Risk ◽  
The Brain

Background: Toxic epidermal necrolysis (TEN) of the scalp is rare but it has been shown to occur in patients who had been given a combination of cranial radiation and anticonvulsant therapies. Objective: We present a 62-year-old man who received cranial irradiation following craniotomy for glioblastoma multiforme. After he was prescribed the anticonvulsant phenytoin for postsurgical seizure prophylaxis, the patient developed TEN which began on the scalp before spreading to involve other parts of his body. Our second case was a 55-year-old woman who had been diagnosed with lung carcinoma with metastasis to the brain. She was treated with cranial irradiation and the anticonvulsant carbamazepine. TEN developed first on the scalp and then became generalized. Conclusions: While the combination of radiation and anticonvulsants leads to an increased risk of developing TEN, cranial irradiation appears to be the localizing factor in the development of TEN of the scalp.

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