Local control and survival after stereotactic radiosurgery for colorectal cancer brain metastases: an international multicenter analysis.

Autor:	Bin-Alamer O; 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Abou-Al-Shaar H; 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Singh R; 2Department of Radiation Oncology, Virginia Commonwealth University Health System, Richmond, Virginia., Mallela AN; 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Legarreta A; 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Bowden G; 3Department of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada., Mathieu D; 4Department of Neurosurgery, Université de Sherbrooke, Quebec, Canada., Perlow HK; Departments of5Radiation Oncology and., Palmer JD; Departments of5Radiation Oncology and.; 6Neurosurgery, The James Cancer Hospital and Solove Research Institute, Ohio State University Wexner Medical Center, Columbus, Ohio., Elhamdani S; Departments of7Neurosurgery and., Shepard M; Departments of7Neurosurgery and., Liang Y; 8Radiation Oncology, Allegheny Health Network, Pittsburgh, Pennsylvania., Nabeel AM; 9Gamma Knife Center, Nasser Institute Hospital, Cairo, Egypt.; 10Department of Neurosurgery, Benha University, Benha, Egypt., Reda WA; 9Gamma Knife Center, Nasser Institute Hospital, Cairo, Egypt.; Departments of11Neurosurgery and., Tawadros SR; 9Gamma Knife Center, Nasser Institute Hospital, Cairo, Egypt.; Departments of11Neurosurgery and., Abdelkarim K; 9Gamma Knife Center, Nasser Institute Hospital, Cairo, Egypt.; 12Clinical Oncology, Ain Shams University, Cairo, Egypt., El-Shehaby AMN; 9Gamma Knife Center, Nasser Institute Hospital, Cairo, Egypt.; Departments of11Neurosurgery and., Emad Eldin R; 9Gamma Knife Center, Nasser Institute Hospital, Cairo, Egypt.; 13Department of Radiation Oncology, National Cancer Institute, Cairo University, Cairo, Egypt., Elazzazi AH; 14Ain Shams University, Cairo, Egypt., Warnick RE; 15Gamma Knife Center, Jewish Hospital, Mayfield Clinic, Cincinnati, Ohio., Gozal YM; 15Gamma Knife Center, Jewish Hospital, Mayfield Clinic, Cincinnati, Ohio., Daly M; 16Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania., McShane B; 16Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania., Addis-Jackson M; 16Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania., Karthikeyan G; 16Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania., Smith S; 16Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania., Picozzi P; 17Department of Neurosurgery, Humanitas Research Hospital-IRCCS, Milan, Italy., Franzini A; 17Department of Neurosurgery, Humanitas Research Hospital-IRCCS, Milan, Italy., Kaisman-Elbaz T; 18Rose Ella Burkhart Brain Tumor and Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio., Yang HC; 19Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.; 20National Yang Ming Chiao Tung University School of Medicine, Hsinchu, Taiwan., Hess J; 21Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut., Templeton K; 21Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut., Zhang X; 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Wei Z; 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Pikis S; Departments of22Neurological Surgery and., Mantziaris G; Departments of22Neurological Surgery and., Simonova G; 23Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic., Liscak R; 23Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic., Peker S; 24Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey; and., Samanci Y; 24Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey; and., Chiang V; 21Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut., Kersh CR; 25Radiation Oncology, University of Virginia, Charlottesville, Virginia., Lee CC; 19Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.; 20National Yang Ming Chiao Tung University School of Medicine, Hsinchu, Taiwan., Trifiletti DM; 26Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, Florida., Niranjan A; 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Hadjipanayis CG; 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Lunsford LD; 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Sheehan JP; 21Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery [J Neurosurg] 2023 Nov 10; Vol. 140 (5), pp. 1233-1242. Date of Electronic Publication: 2023 Nov 10 (Print Publication: 2024).
DOI:	10.3171/2023.8.JNS231231
Abstrakt:	Objective: The goal of this study was to characterize local tumor control (LC), overall survival (OS), and safety of stereotactic radiosurgery for colorectal brain metastasis (CRBM). Methods: Ten international institutions participating in the International Radiosurgery Research Foundation provided data for this retrospective case series. This study included 187 patients with CRBM (281 tumors), with a median age of 62 years and 56.7% being male. Most patients (53.5%) had solitary tumors, although 10.7% had > 5 tumors. The median tumor volume was 2.7 cm3 (IQR 0.22-8.1 cm3), and the median margin dose was 20 Gy (IQR 18-22 Gy). Results: The 3-year LC and OS rates were 72% and 20%, respectively. Symptomatic adverse radiation effects occurred in 1.6% of patients. In the multivariate analysis, age > 65 years and tumor volume > 4.0 cm3 were significant predictors of tumor progression (hazard ratio [HR] 2.6, 95% CI 1.4-4.9; p = 0.003 and HR 3.4, 95% CI 1.7-6.9; p < 0.001, respectively). Better performance status (Karnofsky Performance Scale score > 80) was associated with a reduced risk of tumor progression (HR 0.38, 95% CI 0.19-0.73; p = 0.004). Patient age > 62 years (HR 1.6, 95% CI 1.1-2.3; p = 0.03) and the presence of active extracranial disease (HR 1.7, 95% CI 1.1-2.4; p = 0.009) were significantly associated with worse OS. Conclusions: Stereotactic radiosurgery offers a high LC rate and a low rate of symptomatic adverse radiation effects for the majority of CRBMs. The OS and LC favored younger patients with high functional performance scores and inactive extracranial disease.
Databáze:	MEDLINE
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