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 ◽  
...  

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.

2006 ◽  
Vol 21 (3) ◽  
pp. 527 ◽  
Author(s):  
Doo-Sik Kong ◽  
Jung-Il Lee ◽  
Do Hyun Nam ◽  
Kwan Park ◽  
Jong Hyun Kim ◽  
...  

2012 ◽  
Vol 103 ◽  
pp. S491-S492
Author(s):  
S.N. Badiyan ◽  
D.J. Ferraro ◽  
S. Yaddanapudi ◽  
R.E. Drzymala ◽  
A.Y. Lee ◽  
...  

2019 ◽  
Vol 1 (Supplement_1) ◽  
pp. i23-i23
Author(s):  
Kevin Chaung ◽  
Michael Kharouta ◽  
Stephen Shamp ◽  
Mitchell Machtay ◽  
Andrew Sloan ◽  
...  

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.


2014 ◽  
Vol 16 (suppl 2) ◽  
pp. ii53-ii53
Author(s):  
F. Zairi ◽  
E. Le Rhun ◽  
Y. Ouammou ◽  
R. Aboukais ◽  
M. Vermandel ◽  
...  

2014 ◽  
Vol 125 ◽  
pp. 87-93 ◽  
Author(s):  
Fahed Zairi ◽  
Youssef Ouammou ◽  
Emilie Le Rhun ◽  
Rabih Aboukais ◽  
Serge Blond ◽  
...  

2011 ◽  
Vol 81 (4) ◽  
pp. e463-e468 ◽  
Author(s):  
Micaela Motta ◽  
Antonella del Vecchio ◽  
Luca Attuati ◽  
Piero Picozzi ◽  
Lucia. Perna ◽  
...  

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