+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Outcome appraisal of patients with limited brain metastases (BMs) from non small cell lung cancer (NSCLC) treated with different local therapeutic strategies: a single institute evaluation



Outcome appraisal of patients with limited brain metastases (BMs) from non small cell lung cancer (NSCLC) treated with different local therapeutic strategies: a single institute evaluation



British Journal of Radiology 90(1072): 20170022



To evaluate the outcome of patients with non-small-cell lung cancer (NSCLC) with limited brain metastases (BMs) treated with local approaches omitting whole-brain radiation therapy (WBRT). Surgery was performed in case of a single, large BM, controlled extracranial disease and Karnofsky Performance Status (KPS) 90-100; stereotactic radiosurgery (SRS) or hypofractionated stereotactic radiosurgery (HSRS) was performed in all other cases. The prescribed dose was 24 Gy/1 fraction for lesions <2.5 cm, and a median of 30 Gy (24-40 Gy) in 3-5 fractions for lesions >2.5 cm. 156 patients treated for 228 BMs were retrospectively evaluated. The median age was 62 years. The majority of patients had a KPS 90-100, recursive partitioning analysis Class II, diagnosis-specific graded prognostic assessment score 2.5-3 and 1-2 BMs. Surgical resection was performed in 18 cases, and SRS/HSRS was performed in 210 cases. The 1-2-year local control was 87.2 ± 3.0% and 72.8 ± 5.0%; the 1.2-year brain distant failure was 30.8 ± 4.0% and 58.1 ± 6.0%; the 1-2-year overall survival was 60.9 ± 3.9% and 31.4 ± 4.0%. On univariate and multivariate analysis, the following factors influenced survival: age (p = 0.01), the presence of lymph node involvement (p = 0.03), KPS (p << 0.01), the presence of extracranial metastases at the time of BM treatment (p < 0.01), the number of BMs (p = 0.02) and the treatment performed (p < 0.01). The choice of an adequate local treatment can impact on survival in patients with limited BMs from NSCLC. A careful evaluation of prognostic and predictive factors is a pivotal additional aid. Advances in knowledge: Radiosurgery or surgery followed by radiosurgery on the tumour bed in place of WBRT proved to be an effective treatment influencing outcome. Surgical resection followed by SRS on the tumour bed has to be considered for lesions ≥15 mm, in patients with good KPS, age ≤70 years, adenocarcinoma histology and oligometastatic disease.

(PDF emailed within 0-6 h: $19.90)

Accession: 060055824

Download citation: RISBibTeXText

PMID: 28256924

DOI: 10.1259/bjr.20170022


Related references

Internal dose escalation is associated with increased local control for non-small cell lung cancer (NSCLC) brain metastases treated with stereotactic radiosurgery (SRS). Advances in Radiation Oncology 3(2): 146-153, 2018

Internal Dose-Escalation Safely Increases Local Control for Non-Small Cell Lung Cancer (NSCLC) Brain Metastases Treated With Stereotactic Radiosurgery (SRS). International Journal of Radiation Oncology*biology*physics 93(3): S178-S179, 2015

Outcome and prognostic factors in patients with brain metastases from small-cell lung cancer treated with whole brain radiotherapy. Journal of Neuro-Oncology 134(1): 205-212, 2017

Outcome of Patients with Non-Small Cell Lung Cancer and Brain Metastases Treated with Checkpoint Inhibitors. Journal of Thoracic Oncology 2019, 2019

Prognostic factors and outcome of surgically treated patients with brain metastases of non-small cell lung cancer. Thoracic Cancer 2018, 2018

Therapeutic perspectives for brain metastases in non-oncogene addicted non-small cell lung cancer (NSCLC): Towards a less dismal future?. Critical Reviews in Oncology/Hematology 128: 19-29, 2018

P-201 Long term outcome of multimodality treatment of non small cell lung cancer (NSCLC) brain metastases: Experience of eight years. Lung Cancer 49: S167-S168, 2005

Five-fraction stereotactic radiosurgery (SRS) for single inoperable high-risk non-small cell lung cancer (NSCLC) brain metastases. Radiation Oncology 10: 216, 2016

ZD 1839 in patients with brain metastases from non-small-cell lung cancer (NSCLC): Report of four cases. British Journal of Cancer 89(2): 246-247, 2003

Phase II with Taxol (Paclitaxel) (T), Carboplatin (C) and brain radiotherapy (RT) in patients (PTS) with inoperable brain metastases (BM) of non-small cell lung cancer (NSCLC). Lung Cancer 29(1): 259-260, 2000

P-465 Differences in baseline characteristics between non-small cell lung cancer (NSCLC) and breast cancer (BrCa) patients with brain metastases. Lung Cancer 41: S208-S209, 2003

Prevalence of brain metastases immediately before prophylactic cranial irradiation in limited disease small cell lung cancer patients with complete remission to chemoradiotherapy: a single institution experience. Journal of Thoracic Oncology 3(6): 652-655, 2008

Outcome, quality of life and cognitive function of patients with brain metastases from non-small cell lung cancer treated with whole brain radiotherapy combined with gefitinib or temozolomide. A randomised phase II trial of the Swiss Group for Clinical Cancer Research (SAKK 70/03). European Journal of Cancer 48(3): 377-384, 2012

Do all patients with non small cell lung cancer and brain metastases have a limited survival. Proceedings of the American Association for Cancer Research & American Society of Clinical Oncology 22: 507, 1981

Outcome, quality of life and cognitive function of patients with brain metastases from non-small cell lung cancer treated with whole brain radiotherapy combined with gefitinib or temozolomide A randomised phase II trial of the Swiss Group for Clinical Ca. 2011