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Gamma knife radiosurgery for patients with brain metastases from non–small cell lung cancer: Comparison of survival between <5 and ≥5 metastases

BACKGROUND: Current evidence‐based guidelines support stereotactic radiosurgery (SRS) for patients with up to four brain metastases (BMs). However, debate continues about how many tumors may be treated by SRS alone. METHODS: This retrospective study included non–small cell lung cancer (NSCLC) patien...

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Autores principales: Zhao, Xu, Ding, Shouluan, Zhang, Ming, Wang, Chengwei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9346171/
https://www.ncbi.nlm.nih.gov/pubmed/35770337
http://dx.doi.org/10.1111/1759-7714.14532
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author Zhao, Xu
Ding, Shouluan
Zhang, Ming
Wang, Chengwei
author_facet Zhao, Xu
Ding, Shouluan
Zhang, Ming
Wang, Chengwei
author_sort Zhao, Xu
collection PubMed
description BACKGROUND: Current evidence‐based guidelines support stereotactic radiosurgery (SRS) for patients with up to four brain metastases (BMs). However, debate continues about how many tumors may be treated by SRS alone. METHODS: This retrospective study included non–small cell lung cancer (NSCLC) patients with BMs treated with gamma knife as the initial treatment for cerebral lesions. The patients were followed up to obtain their survival information. The outcomes were statistically analyzed to compare the differences in survival between the <5 BMs and ≥5 BMs groups and to identify prognostic factors. RESULTS: A total of 77 patients were divided into two groups (54 patients with <5 BMs and 23 patients with ≥5 BMs). The median overall survival (OS) was 18.3 months in the <5 BMs group and 17.7 months in the ≥5 BMs group. The median intracranial progression‐free survival (IPFS) was 9.0 months in the <5 BMs group and 9.9 months in the ≥5 BMs group. There was no significant difference in OS and IPFS between the two groups. The multivariate analysis demonstrated that adenocarcinoma, controlled primary cancer, higher Karnofsky Performance Scale (KPS), and salvage treatment were independent prognostic factors favoring longer OS. CONCLUSION: SRS alone as the initial treatment for NSCLC patients with more than four BMs was non‐inferior to SRS for those with one to four BMs in terms of OS and IPFS.
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spelling pubmed-93461712022-08-05 Gamma knife radiosurgery for patients with brain metastases from non–small cell lung cancer: Comparison of survival between <5 and ≥5 metastases Zhao, Xu Ding, Shouluan Zhang, Ming Wang, Chengwei Thorac Cancer Original Articles BACKGROUND: Current evidence‐based guidelines support stereotactic radiosurgery (SRS) for patients with up to four brain metastases (BMs). However, debate continues about how many tumors may be treated by SRS alone. METHODS: This retrospective study included non–small cell lung cancer (NSCLC) patients with BMs treated with gamma knife as the initial treatment for cerebral lesions. The patients were followed up to obtain their survival information. The outcomes were statistically analyzed to compare the differences in survival between the <5 BMs and ≥5 BMs groups and to identify prognostic factors. RESULTS: A total of 77 patients were divided into two groups (54 patients with <5 BMs and 23 patients with ≥5 BMs). The median overall survival (OS) was 18.3 months in the <5 BMs group and 17.7 months in the ≥5 BMs group. The median intracranial progression‐free survival (IPFS) was 9.0 months in the <5 BMs group and 9.9 months in the ≥5 BMs group. There was no significant difference in OS and IPFS between the two groups. The multivariate analysis demonstrated that adenocarcinoma, controlled primary cancer, higher Karnofsky Performance Scale (KPS), and salvage treatment were independent prognostic factors favoring longer OS. CONCLUSION: SRS alone as the initial treatment for NSCLC patients with more than four BMs was non‐inferior to SRS for those with one to four BMs in terms of OS and IPFS. John Wiley & Sons Australia, Ltd 2022-06-29 2022-08 /pmc/articles/PMC9346171/ /pubmed/35770337 http://dx.doi.org/10.1111/1759-7714.14532 Text en © 2022 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Zhao, Xu
Ding, Shouluan
Zhang, Ming
Wang, Chengwei
Gamma knife radiosurgery for patients with brain metastases from non–small cell lung cancer: Comparison of survival between <5 and ≥5 metastases
title Gamma knife radiosurgery for patients with brain metastases from non–small cell lung cancer: Comparison of survival between <5 and ≥5 metastases
title_full Gamma knife radiosurgery for patients with brain metastases from non–small cell lung cancer: Comparison of survival between <5 and ≥5 metastases
title_fullStr Gamma knife radiosurgery for patients with brain metastases from non–small cell lung cancer: Comparison of survival between <5 and ≥5 metastases
title_full_unstemmed Gamma knife radiosurgery for patients with brain metastases from non–small cell lung cancer: Comparison of survival between <5 and ≥5 metastases
title_short Gamma knife radiosurgery for patients with brain metastases from non–small cell lung cancer: Comparison of survival between <5 and ≥5 metastases
title_sort gamma knife radiosurgery for patients with brain metastases from non–small cell lung cancer: comparison of survival between <5 and ≥5 metastases
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9346171/
https://www.ncbi.nlm.nih.gov/pubmed/35770337
http://dx.doi.org/10.1111/1759-7714.14532
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