Local control and overall survival for adjuvant stereotactic radiosurgery in patients with residual or recurrent disease
| Autor: | Tony J. C. Wang, Andrew B. Lassman, Yasir H. Qureshi, Shumaila Saad, Andrew Yaeh, Michael B. Sisti, Steven R. Isaacson, Jeraldine Lesser, Cheng-Chia Wu, Sameer A. Sheth, Keith A. Cauley, Simon K. Cheng, Guy M. McKhann, Tavish Nanda, Jeffrey N. Bruce, Ashish Jani |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Neoplasm Residual medicine.medical_treatment Urology Kaplan-Meier Estimate Radiosurgery 03 medical and health sciences 0302 clinical medicine parasitic diseases medicine Recurrent disease Overall survival Humans In patient Retrospective Studies Brain Neoplasms business.industry Significant difference Local failure Middle Aged Treatment efficacy Treatment Outcome Neurology Oncology 030220 oncology & carcinogenesis Disease Progression Female Radiotherapy Adjuvant Neurology (clinical) Neoplasm Recurrence Local business Adjuvant 030217 neurology & neurosurgery |
| Zdroj: | Journal of Neuro-Oncology. 136:281-287 |
| ISSN: | 1573-7373 0167-594X |
| Popis: | Prior studies of post-operative stereotactic radiosurgery (SRS) have not distinguished between Adjuvant SRS (ARS) versus Adjuvant SRS to residual/recurrent disease (ARD). In this study, we defined ARS and ARD and investigated local control (LC), overall survival (OS), distant development of brain metastases (DBF), and leptomeningeal disease (LMD). We retrospectively identified BM patients who received surgical resection and SRS for BM from an IRB approved database between Jan 2009-Aug 2015. Patients were stratified into two groups: ARS and ARD. LC was determined by follow-up MRI studies and OS was measured from the date of surgery. LC and OS were assessed using the Kaplan-Meier method. 70 cavities underwent surgical resection of BM and received SRS to the post-operative bed. 41 cavities were classified as ARS and 29 as ARD. There was no significant difference in 12-month LC between the ARS and ARD group (71.4 vs. 80.8%, respectively; p = 0.135) from the time point of SRS. The overall 1-year survival for ARS and ARD was 79.9 and 86.1%, respectively (p = 0.339). Mean time to progression was 6.45 and 8.0 months and median follow-up was 10 and 15 months for ARS and ARD, respectively. 11.8% of ARS patients and 15.4% of ARD patients developed LMD, p = 0.72. 29.4% of ARS and 48.0% of ARD patients developed DBF, p = 0.145. Our findings suggest that observation after surgical resection, with subsequent treatment with SRS after the development of local failure, may not compromise treatment efficacy. If validated, this would spare patients who do not recur post-surgically from additional treatment. |
| Databáze: | OpenAIRE |
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