Long-term survival in patients with synchronous, solitary brain metastasis from non-small-cell lung cancer treated with radiosurgery
| Autor: | William F. Regine, Mohan Suntharalingam, Marnie Kremer, Mark J. Krasna, Young Kwok, Todd W. Flannery, Roy A. Patchell, Lawrence S. Chin, Michael K. Shehata, Martin J. Edelman |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Lung Neoplasms Survival medicine.medical_treatment Kentucky Radiosurgery Carcinoma Non-Small-Cell Lung medicine Carcinoma Humans Radiology Nuclear Medicine and imaging Stage (cooking) Karnofsky Performance Status Lung cancer Aged Neoplasm Staging Retrospective Studies Chemotherapy Radiation Maryland business.industry Brain Neoplasms Cancer Radiotherapy Dosage Middle Aged medicine.disease Surgery Radiation therapy Treatment Outcome Oncology business Brain metastasis |
| Zdroj: | International journal of radiation oncology, biology, physics. 72(1) |
| ISSN: | 0360-3016 |
| Popis: | To report the outcome of patients with synchronous, solitary brain metastasis from non-small-cell lung cancer (NSCLC) treated with gamma knife stereotactic radiosurgery (GKSRS).Forty-two patients diagnosed with synchronous, solitary brain metastasis from NSCLC were treated with GKSRS between 1993 and 2006. The median Karnofsky performance status (KPS) was 90. Patients had thoracic Stage I-III disease (American Joint Committee on Cancer 2002 guidelines). Definitive thoracic therapy was delivered to 26/42 (62%) patients; 9 patients underwent chemotherapy and radiation, 12 patients had surgical resection, and 5 patients underwent preoperative chemoradiation and surgical resection.The median overall survival (OS) was 18 months. The 1-, 2-, and 5-year actuarial OS rates were 71.3%, 34.1%, and 21%, respectively. For patients who underwent definitive thoracic therapy, the median OS was 26.4 months compared with 13.1 months for those who had nondefinitive therapy, and the 5-year actuarial OS was 34.6% vs. 0% (p0.0001). Median OS was significantly longer for patients with a KPSor=90 vs. KPS90 (27.8 months vs. 13.1 months, p0.0001). The prognostic factors significant on multivariate analysis were definitive thoracic therapy (p = 0.020) and KPS (p = 0.001).This is one of the largest series of patients diagnosed with synchronous, solitary brain metastasis from NSCLC treated with GKSRS. Definitive thoracic therapy and KPS significantly impacted OS. The 5-year OS of 21% demonstrates the potential for long-term survival in patients treated with GKSRS; therefore, patients with good KPS should be considered for definitive thoracic therapy. |
| Databáze: | OpenAIRE |
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