Stereotactic Radiosurgery for Patients With Brain Metastases From Small Cell Lung Cancer

Journal Article · Tue Nov 01 04:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2011.01.001· OSTI ID:21590419

Wegner, Rodney E; Olson, Adam C ^[1]; Kondziolka, Douglas; Niranjan, Ajay; Lundsford, L Dade ^[2]

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1. Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States)
2. Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States)

Background: Patients with small-cell lung cancer have a high likelihood of developing brain metastases. Many of these patients will have prophylactic cranial irradiation (PCI) or eventually undergo whole brain radiation therapy (WBRT). Despite these treatments, a large number of these patients will have progression of their intracranial disease and require additional local therapy. Stereotactic radiosurgery (SRS) is an important treatment option for such patients. Methods: We retrospectively reviewed the charts of 44 patients with brain metastases from small-cell lung cancer treated with gamma knife SRS. Multivariate analysis was used to determine significant prognostic factors influencing survival. Results: The median follow-up from SRS in this patient population was 9 months (1-49 months). The median overall survival (OS) was 9 months after SRS. Karnofsky performance status (KPS) and combined treatment involving WBRT and SRS within 4 weeks were the two factors identified as being significant predictors of increased OS (p = 0.033 and 0.040, respectively). When comparing all patients, patients treated with a combined approach had a median OS of 14 months compared to 6 months if SRS was delivered alone. We also compared the OS times from the first definitive radiation: WBRT, WBRT and SRS if combined therapy was used, and SRS if the patient never received WBRT. The median survival for those groups was 12, 14, and 13 months, respectively, p = 0.19. Seventy percent of patients had follow-up magnetic resonance imaging available for review. Actuarial local control at 6 months and 12 months was 90% and 86%, respectively. Only 1 patient (2.2%) had symptomatic intracranial swelling related to treatment, which responded to a short course of steroids. New brain metastases outside of the treated area developed in 61% of patients at a median time of 7 months; 81% of these patients had received previous WBRT. Conclusions: Stereotactic radiosurgery for small-cell lung carcinoma brain metastases provided safe and effective local tumor control in the majority of patients.

• OSTI ID: 21590419
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 81; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
BRAIN
CARCINOMAS
CENTRAL NERVOUS SYSTEM
COMBINED THERAPY
DEFORMATION
DIAGNOSTIC TECHNIQUES
DISEASES
IRRADIATION
LUNGS
MATHEMATICS
MEDICINE
METASTASES
MULTIVARIATE ANALYSIS
NEOPLASMS
NERVOUS SYSTEM
NMR IMAGING
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANS
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
STATISTICS
STEROIDS
SURGERY
SWELLING
THERAPY