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RADI-07. GAMMA KNIFE RADIOSURGERY FOR SMALL CELL LUNG CANCER: PROGNOSTIC FACTORS INCLUDING ADDITIONAL LESIONS IDENTIFIED ON THE DAY OF RADIOSURGERY
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)...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213300/ http://dx.doi.org/10.1093/noajnl/vdz014.100 |
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author | Chaung, Kevin Kharouta, Michael Shamp, Stephen Machtay, Mitchell Sloan, Andrew Bhatt, Aashish Mansur, David Hodges, Tiffany Zhang, Yuxia Choi, Serah |
author_facet | Chaung, Kevin Kharouta, Michael Shamp, Stephen Machtay, Mitchell Sloan, Andrew Bhatt, Aashish Mansur, David Hodges, Tiffany Zhang, Yuxia Choi, Serah |
author_sort | Chaung, Kevin |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7213300 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-72133002020-07-07 RADI-07. GAMMA KNIFE RADIOSURGERY FOR SMALL CELL LUNG CANCER: PROGNOSTIC FACTORS INCLUDING ADDITIONAL LESIONS IDENTIFIED ON THE DAY OF RADIOSURGERY Chaung, Kevin Kharouta, Michael Shamp, Stephen Machtay, Mitchell Sloan, Andrew Bhatt, Aashish Mansur, David Hodges, Tiffany Zhang, Yuxia Choi, Serah Neurooncol Adv Abstracts 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. Oxford University Press 2019-08-12 /pmc/articles/PMC7213300/ http://dx.doi.org/10.1093/noajnl/vdz014.100 Text en © The Author(s) 2019. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Abstracts Chaung, Kevin Kharouta, Michael Shamp, Stephen Machtay, Mitchell Sloan, Andrew Bhatt, Aashish Mansur, David Hodges, Tiffany Zhang, Yuxia Choi, Serah RADI-07. GAMMA KNIFE RADIOSURGERY FOR SMALL CELL LUNG CANCER: PROGNOSTIC FACTORS INCLUDING ADDITIONAL LESIONS IDENTIFIED ON THE DAY OF RADIOSURGERY |
title | RADI-07. GAMMA KNIFE RADIOSURGERY FOR SMALL CELL LUNG CANCER: PROGNOSTIC FACTORS INCLUDING ADDITIONAL LESIONS IDENTIFIED ON THE DAY OF RADIOSURGERY |
title_full | RADI-07. GAMMA KNIFE RADIOSURGERY FOR SMALL CELL LUNG CANCER: PROGNOSTIC FACTORS INCLUDING ADDITIONAL LESIONS IDENTIFIED ON THE DAY OF RADIOSURGERY |
title_fullStr | RADI-07. GAMMA KNIFE RADIOSURGERY FOR SMALL CELL LUNG CANCER: PROGNOSTIC FACTORS INCLUDING ADDITIONAL LESIONS IDENTIFIED ON THE DAY OF RADIOSURGERY |
title_full_unstemmed | RADI-07. GAMMA KNIFE RADIOSURGERY FOR SMALL CELL LUNG CANCER: PROGNOSTIC FACTORS INCLUDING ADDITIONAL LESIONS IDENTIFIED ON THE DAY OF RADIOSURGERY |
title_short | RADI-07. GAMMA KNIFE RADIOSURGERY FOR SMALL CELL LUNG CANCER: PROGNOSTIC FACTORS INCLUDING ADDITIONAL LESIONS IDENTIFIED ON THE DAY OF RADIOSURGERY |
title_sort | radi-07. gamma knife radiosurgery for small cell lung cancer: prognostic factors including additional lesions identified on the day of radiosurgery |
topic | Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213300/ http://dx.doi.org/10.1093/noajnl/vdz014.100 |
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