Comparison of first-line radiosurgery for small-cell and non-small cell lung cancer brain metastases (CROSS-FIRE)

被引：13

作者：

Rusthoven, Chad G. ^{[1
]}

Staley, Alyse W. ^{[2
]}

Gao, Dexiang ^{[2
]}

Yomo, Shoji ^{[3
]}

Bernhardt, Denise ^{[4
]}

Wandrey, Narine ^{[1
]}

El Shafie, Rami ^{[5
,6
]}

Kraemer, Anna ^{[5
,7
,8
]}

Padilla, Oscar ^{[9
]}

Chiang, Veronica ^{[10
]}

Faramand, Andrew M. ^{[11
]}

Palmer, Joshua D. ^{[12
]}

Zacharia, Brad E. ^{[13
]}

Wegner, Rodney E. ^{[14
]}

Hattangadi-Gluth, Jona A. ^{[15
]}

Levy, Antonin ^{[16
]}

Bernstein, Kenneth ^{[17
]}

Mathieu, David ^{[18
]}

Cagney, Daniel N. ^{[19
]}

Chan, Michael D. ^{[20
]}

Grills, Inga S. ^{[21
]}

Braunstein, Steve ^{[22
]}

Lee, Cheng-Chia ^{[23
]}

Sheehan, Jason P. ^{[24
]}

Kluwe, Christien ^{[25
]}

Patel, Samir ^{[26
]}

Halasz, Lia M. ^{[27
]}

Andratschke, Nicolaus ^{[28
]}

Deibert, Christopher P. ^{[29
]}

Verma, Vivek ^{[30
]}

Trifiletti, Daniel M. ^{[31
]}

Cifarelli, Christopher P. ^{[32
]}

Debus, Juergen ^{[5
,7
,8
,33
]}

Combs, Stephanie E. ^{[4
]}

Sato, Yasunori ^{[34
]}

Higuchi, Yoshinori ^{[35
]}

Aoyagi, Kyoko ^{[36
]}

Brown, Paul D. ^{[37
]}

Alami, Vida ^{[2
]}

Niranjan, Ajay ^{[11
]}

Lunsford, L. Dade ^{[11
]}

Kondziolka, Douglas ^{[38
]}

Camidge, D. Ross ^{[39
]}

Kavanagh, Brian D. ^{[1
]}

Robin, Tyler P. ^{[1
]}

Serizawa, Toru ^{[40
]}

Yamamoto, Masaaki ^{[41
]}

机构：

[1] Univ Colorado, Dept Radiat Oncol, Sch Med, 1665 Aurora Ct,Suite 1032, Aurora, CO 80045 USA

[2] Univ Colorado, Biostat Core, Canc Ctr, Aurora, CO USA

[3] Aizawa Hosp, Aizawa Comprehens Canc Ctr, Div Radiat Oncol, Matsumoto, Japan

[4] Tech Univ Munich TUM, Dept Radiat Oncol, Munich, Germany

[5] Heidelberg Univ Hosp, Dept Radiat Oncol, Munich, Germany

[6] Univ Med Ctr Gottingen, Dept Radiat Oncol, Gottingen, Germany

[7] Heidelberg Inst Radiat Oncol HIRO, Natl Ctr Radiat Oncol NCRO, Heidelberg, Germany

[8] Natl Ctr Tumor Dis NCT, Heidelberg, Germany

[9] Columbia Univ, Dept Radiat Oncol, Irving Med Ctr, New York, NY USA

[10] Yale Univ, Dept Neurosurg, Sch Med, New Haven, CT USA

[11] Univ Pittsburgh, Dept Neurosurg, Med Ctr, Pittsburgh, PA USA

[12] Ohio State Univ, Dept Radiat Oncol, James Comprehens Canc Ctr, Wexner Med Ctr, Columbus, OH USA

[13] Penn State Hlth Milton S Hershey Med Ctr, Dept Neurosurg, Hershey, PA USA

[14] Allegheny Hlth Network Canc Inst, Div Radiat Oncol, Pittsburgh, PA USA

[15] Univ Calif San Diego, Dept Radiat Med & Appl Sci, La Jolla, CA USA

[16] Univ Paris Saclay, Dept Radiat Oncol, Gustave Roussy, Villejuif, France

[17] New York Univ, Dept Radiat Oncol, Langone Med Ctr, New York, NY USA

[18] Univ Sherbrooke, Ctr Rech CHUS, Div Neurosurg, Sherbrooke, PQ, Canada

[19] Harvard Med Sch, Dana Farber Canc Inst, Dept Radiat Oncol, Boston, MA USA

[20] Wake Forest Univ, Dept Radiat Oncol, Sch Med, Winston Salem, NC USA

[21] Beaumont Hlth Syst, Dept Radiat Oncol, Royal Oak, MI USA

[22] Univ Calif San Francisco, Dept Radiat Oncol, San Francisco, CA USA

[23] Taipei Vet Gen Hosp, Neurol Inst, Dept Neurosurg, Taipei, Taiwan

[24] Univ Virginia, Dept Neurol Surg, Charlottesville, VA USA

[25] Vanderbilt Univ, Dept Radiat Oncol, Nashville, TN USA

[26] Univ Alberta, Dept Oncol, Div Radiat Oncol, Edmonton, AB, Canada

[27] Univ Washington, Dept Radiat Oncol, Sch Med, Seattle, WA USA

[28] Univ Zurich, Univ Hosp Zurich USZ, Dept Radiat Oncol, Zurich, Switzerland

[29] Emory Univ, Dept Neurosurg, Atlanta, GA USA

[30] MD Anderson Canc Ctr, Dept Radiat Oncol, Houston, TX USA

[31] Mayo Clin Jacksonville, Dept Radiat Oncol, Jacksonville, FL USA

[32] West Virginia Univ, Dept Neurosurg, Morgantown, WV USA

[33] German Canc Res Ctr, Deutsch Konsortium Translat Krebsforschung DKTK, Partner Site Heidelberg, Heidelberg, Germany

[34] Keio Univ, Dept Prevent Med & Publ Hlth, Sch Med, Tokyo, Japan

[35] Chiba Univ, Dept Neurol Surg, Grad Sch Med, Chiba, Japan

[36] Chiba Cerebral & Cardiovasc Ctr, Gamma Knife House, Chiba, Japan

[37] Mayo Clin, Dept Radiat Oncol, Rochester, MN USA

[38] New York Univ, Dept Neurosurg & Radiat Oncol, Langone Med Ctr, New York, NY USA

[39] Univ Colorado, Div Med Oncol, Sch Med, Aurora, CO USA

[40] Tokyo Gamma Unit Ctr, Tsukiji Neurol Clin, Tokyo, Japan

[41] Katsuta Hosp Mito GammaHouse, Hitachi Naka, Japan

来源：

JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE | 2023年 / 115卷 / 08期

关键词：

PROPHYLACTIC CRANIAL IRRADIATION; CLINICAL-PRACTICE GUIDELINES; STEREOTACTIC RADIOSURGERY; FOLLOW-UP; MUTATIONS; TUMORS; RADIOTHERAPY; GEFITINIB; CARCINOMA; DIAGNOSIS;

D O I：

10.1093/jnci/djad073

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Introduction Historical reservations regarding stereotactic radiosurgery (SRS) for small-cell lung cancer (SCLC) brain metastases include concerns for short-interval and diffuse central nervous system (CNS) progression, poor prognoses, and increased neurological mortality specific to SCLC histology. We compared SRS outcomes for SCLC and non-small cell lung cancer (NSCLC) where SRS is well established. Methods Multicenter first-line SRS outcomes for SCLC and NSCLC from 2000 to 2022 were retrospectively collected (n = 892 SCLC, n = 4785 NSCLC). Data from the prospective Japanese Leksell Gamma Knife Society (JLGK0901) clinical trial of first-line SRS were analyzed as a comparison cohort (n = 98 SCLC, n = 814 NSCLC). Overall survival (OS) and CNS progression were analyzed using Cox proportional hazard and Fine-Gray models, respectively, with multivariable adjustment for cofactors including age, sex, performance status, year, extracranial disease status, and brain metastasis number and volume. Mutation-stratified analyses were performed in propensity score-matched retrospective cohorts of epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) positive NSCLC, mutation-negative NSCLC, and SCLC. Results OS was superior for patients with NSCLC compared to SCLC in the retrospective dataset (median OS = 10.5 vs 8.6 months; P < .001) and in the JLGK0901 dataset. Hazard estimates for first CNS progression favoring NSCLC were similar in both datasets but reached statistical significance in the retrospective dataset only (multivariable hazard ratio = 0.82, 95% confidence interval = 0.73 to 0.92, P = .001). In the propensity score-matched cohorts, there were continued OS advantages for NSCLC patients (median OS = 23.7 [EGFR and ALK positive NSCLC] vs 13.6 [mutation-negative NSCLC] vs 10.4 months [SCLC], pairwise P values < 0.001), but no statistically significant differences in CNS progression were observed in the matched cohorts. Neurological mortality and number of lesions at CNS progression were similar for NSCLC and SCLC patients. Leptomeningeal progression was increased in patients with NSCLC compared to SCLC in the retrospective dataset only (multivariable hazard ratio = 1.61, 95% confidence interval = 1.14 to 2.26, P = .007). Conclusions After SRS, SCLC histology was associated with shorter OS compared to NSCLC. CNS progression occurred earlier in SCLC patients overall but was similar in patients matched on baseline factors. SCLC was not associated with increased neurological mortality, number of lesions at CNS progression, or leptomeningeal progression compared to NSCLC. These findings may better inform clinical expectations and individualized decision making regarding SRS for SCLC patients.

引用

页码：926 / 936

页数：11

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