Stereotactic radiosurgery for brain metastasis in non-small cell lung cancer.
10.3857/roj.2015.33.3.207
- Author:
Yong Kyun WON
1
;
Ja Young LEE
;
Young Nam KANG
;
Ji Sun JANG
;
Jin Hyoung KANG
;
So Lyoung JUNG
;
Soo Yoon SUNG
;
In Young JO
;
Hee Hyun PARK
;
Dong Soo LEE
;
Ji Hyun CHANG
;
Yun Hee LEE
;
Yeon Sil KIM
Author Information
1. Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. yeonkim7@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Brain neoplasm;
Neoplasm metastasis;
Non-small-cell lung carcinoma;
Radiosurgery;
Prognosis
- MeSH:
Brain Neoplasms;
Brain*;
Carcinoma, Non-Small-Cell Lung*;
Disease-Free Survival;
Follow-Up Studies;
Humans;
Lung Diseases;
Magnetic Resonance Imaging;
Necrosis;
Neoplasm Metastasis*;
Prognosis;
Radiosurgery*;
Recurrence;
Retrospective Studies;
Treatment Outcome
- From:Radiation Oncology Journal
2015;33(3):207-216
- CountryRepublic of Korea
- Language:English
-
Abstract:
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. > or =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.
