Upfront radiosurgery plus targeted agents followed by active brain control using radiosurgery delays neurological death in non-small cell lung cancer with brain metastasis
| Autor: | Young Nam Kang, J.H. Kang, Seung Joon Kim, Yeon-Sil Kim, So Lyung Jung, Yoo-Kang Kwak, Soo Yoon Sung, Ji Sun Jang, Sea-Won Lee, Sook-Hee Hong |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male 0301 basic medicine Oncology Brain Death Cancer Research medicine.medical_specialty Lung Neoplasms Time Factors medicine.medical_treatment Brain control Salvage therapy Radiosurgery Disease-Free Survival 03 medical and health sciences 0302 clinical medicine Carcinoma Non-Small-Cell Lung Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Lung cancer Survival rate Aged Retrospective Studies Aged 80 and over Salvage Therapy Brain Neoplasms business.industry Brain Dose-Response Relationship Radiation Chemoradiotherapy General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging 030104 developmental biology 030220 oncology & carcinogenesis Female CyberKnife Radiosurgery Non small cell business Follow-Up Studies Brain metastasis |
| Zdroj: | Clinical & Experimental Metastasis. 37:353-363 |
| ISSN: | 1573-7276 0262-0898 |
| Popis: | The role of radiosurgery has become further accentuated in the era of targeted agents (TA). Thus, the neurologic outcome of radiosurgery in brain metastasis (BM) of non-small cell lung cancer (NSCLC) was reviewed. We analyzed 135 patients with BM of NSCLC who were administered Cyberknife radiosurgery (CKRS) as either initial or salvage therapy. We evaluated local failure (LF), intracranial failure (IF), and neurological death (ND) due to BM. Primary outcome was neurological death-free survival (NDFS). Median follow-up was 16.2 months. Median CKRS dose of 22 Gy was administered to median 2 targets per patient. Among 99 deaths, 14 (14%) were ND. Upfront treatment for BM included CKRS alone in 85 patients (63%), CKRS + TA in 26 patients (19%), and WBRT in 24 patients (18%). No patients or tumor related factors were associated with ND. However, the type of upfront treatment for BM was significantly associated with ND [HR 0.07 (95% CI 0.01–0.57) for CKRS + TA, HR 0.56 (95% CI 0.19–1.68) for CKRS alone] compared with the WBRT group (P = 0.01). The 2-year NDFS rates for the CKRS + TA, CRKS alone, and WBRT groups were 94%, 87%, and 78%, respectively (P = 0.03). Upfront CKRS showed significantly higher 2-year LF-free survival rate (P |
| Databáze: | OpenAIRE |
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