Five-year survivors from brain metastases treated with stereotactic radiosurgery: Biology, improving treatments, or just plain luck?

Autor: Pearce, Jane B, Hsu, Fang-Chi, Lanier, Claire M, Cramer, Christina K, Ruiz, Jimmy, Lo, Hui-Wen, Xing, Fei, Smith, Margaret, Li, Wencheng, Whitlow, Christopher, White, Jaclyn J, Tatter, Stephen B, Laxton, Adrian W, Chan, Michael D
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Zdroj: Neuro-Oncology Practice; Apr2023, Vol. 10 Issue 2, p195-202, 8p
Abstrakt: Background Improvements in therapies have led to an increasing number of long-term survivors of brain metastases. The present series compares a population of 5-year survivors of brain metastases to a generalized brain metastases population to assess for factors attributable to long-term survival. Methods A single institution retrospective review was performed to identify 5-year survivors of brain metastases who received stereotactic radiosurgery (SRS). A historical control population of 737 patients with brain metastases was used to assess similarities and differences between the long-term survivor population and the general population treated with SRS. Results A total of 98 patients with brain metastases were found to have survived over 60 months. No differences between long-term survivors and controls were identified with regards to the age at first SRS (P  = .19), primary cancer distribution (P  = .80), and the number of metastases at first SRS (P  = .90). Cumulative incidence of neurologic death at 6, 8 and 10 years for the long-term survivor cohort was 4.8%, 16%, and 16% respectively. In the historical controls, cumulative incidence of neurologic death reached a plateau at 40% after 4.9 years. A significant difference in the distribution of burden of disease at the time of the first SRS was found between the 5-year survivors and the control (P  = .0049). 58% of 5-year survivors showed no evidence of clinical disease at the last follow-up. Conclusion Five-year survivors of brain metastases represent a diverse histologic population, suggesting a small population of oligometastatic and indolent cancers exist for each cancer type. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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