Stereotactic radiosurgery for brain metastasis in non-small cell lung cancer

被引：39

作者：

Won, Yong Kyun ^{[1
]}

Lee, Ja Young ^{[2
]}

Kang, Young Nam ^{[1
]}

Jang, Ji Sun ^{[1
]}

Kang, Jin-Hyoung ^{[3
]}

Jung, So-Lyoung ^{[4
]}

Sung, Soo Yoon ^{[1
]}

Jo, In Young ^{[5
]}

Park, Hee Hyun ^{[1
]}

Lee, Dong-Soo ^{[6
]}

Chang, Ji Hyun ^{[1
]}

Lee, Yun Hee ^{[1
]}

Kim, Yeon-Sil ^{[1
]}

机构：

[1] Catholic Univ Korea Coll Med, Seoul St Marys Hosp, Dept Radiat Oncol, 222 Banpo Daero, Seoul 06591, South Korea

[2] Pusan Natl Univ, Yangsan Hosp, Dept Radiat Oncol, Yangsan, South Korea

[3] Catholic Univ Korea Coll Med, Seoul St Marys Hosp, Dept Med Oncol, Seoul, South Korea

[4] Catholic Univ Korea Coll Med, Seoul St Marys Hosp, Dept Radiol, Seoul, South Korea

[5] Catholic Univ Korea Coll Med, Incheon St Marys Hosp, Dept Radiat Oncol, Incheon, South Korea

[6] Catholic Univ Korea Coll Med, Uijeongbu St Marys Hosp, Dept Radiat Oncol, Uijongbu, South Korea

来源：

RADIATION ONCOLOGY JOURNAL | 2015年 / 33卷 / 03期

关键词：

Brain neoplasm; Neoplasm metastasis; Non-small-cell lung carcinoma; Radiosurgery; Prognosis;

D O I：

10.3857/roj.2015.33.3.207

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: Stereotactic radiosurgery (SRS) has been introduced for small-sized single and oligo-metastases in the brain. The aim of this study is to assess treatment outcome, efficacy, and prognostic variables associated with survival and intracranial recurrence. Materials and Methods: This study retrospectively reviewed 123 targets in 64 patients with non-small cell lung cancer (NSCLC) treated with SRS between January 2006 and December 2012. Treatment responses were evaluated using magnetic resonance imaging. Overall survival (OS) and intracranial progression-free survival (IPFS) were determined. Results: The median follow-up was 13.9 months. The median OS and IPFS were 14.1 and 8.9 months, respectively. Fifty-seven patients died during the follow-up period. The 5-year local control rate was achieved in 85% of 108 evaluated targets. The 1- and 2-year OS rates were 55% and 28%, respectively. On univariate analysis, primary disease control (p < 0.001), the Eastern Cooperative Oncology Group (ECOG) performance status (0-1 vs. 2; p = 0.002), recursive partitioning analysis class (1 vs. 2; p = 0.001), and age (< 65 vs. >= 65 years; p = 0.036) were significant predictive factors for OS. Primary disease control (p = 0.041) and ECOG status (p = 0.017) were the significant prognostic factors for IPFS. Four patients experienced radiation necrosis. Conclusion: SRS is a safe and effective local treatment for brain metastases in patients with NSCLC. Uncontrolled primary lung disease and ECOG status were significant predictors of OS and intracranial failure. SRS might be a tailored treatment option along with careful follow-up of the intracranial and primary lung disease status.

引用

页码：207 / 216

页数：10

共 33 条

[1] Peacock K.H., Lesser G.J., Current therapeutic approaches in patients with brain metastases, Curr Treat Options Oncol, 7, pp. 479-489, (2006)
[2] Cairncross J.G., Kim J.H., Posner J.B., Radiation therapy for brain metastases, Ann Neurol, 7, pp. 529-541, (1980)
[3] Diener-West M., Dobbins T.W., Phillips T.L., Nelson D.F., Identification of an optimal subgroup for treatment evaluation of patients with brain metastases using RTOG study 7916, Int J Radiat Oncol Biol Phys, 16, pp. 669-673, (1989)
[4] Kazda T., Jancalek R., Pospisil P., Et al., Why and how to spare the hippocampus during brain radiotherapy: The developing role of hippocampal avoidance in cranial radiotherapy, Radiat Oncol, 9, (2014)
[5] Patchell R.A., Tibbs P.A., Walsh J.W., Et al., A randomized trial of surgery in the treatment of single metastases to the brain, N Engl J Med, 322, pp. 494-500, (1990)
[6] Noordijk E.M., Vecht C.J., Haaxma-Reiche H., Et al., The choice of treatment of single brain metastasis should be based on extracranial tumor activity and age, Int J Radiat Oncol Biol Phys, 29, pp. 711-717, (1994)
[7] Mehta M.P., Tsao M.N., Whelan T.J., Et al., The American Society for Therapeutic Radiology and Oncology (ASTRO) evidence-based review of the role of radiosurgery for brain metastases, Int J Radiat Oncol Biol Phys, 63, pp. 37-46, (2005)
[8] Lester-Coll N.H., Dosoretz A.P., Yu J.B., Decision analysis of stereotactic radiation surgery versus stereotactic radiation surgery and whole-brain radiation therapy for 1 to 3 brain metastases, Int J Radiat Oncol Biol Phys, 89, pp. 563-568, (2014)
[9] Li J., Bentzen S.M., Renschler M., Mehta M.P., Regression after whole-brain radiation therapy for brain metastases correlates with survival and improved neurocognitive function, J Clin Oncol, 25, pp. 1260-1266, (2007)
[10] Wegner R.E., Olson A.C., Kondziolka D., Niranjan A., Lundsford L.D., Flickinger J.C., Stereotactic radiosurgery for patients with brain metastases from small cell lung cancer, Int J Radiat Oncol Biol Phys, 81, pp. 21-27, (2011)

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