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Title: Gamma Knife Radiosurgery for Treatment of Cerebral Metastases From Non-Small-Cell Lung Cancer

Abstract

Purpose: To evaluate clinical and physico-dosimetric variables affecting clinical outcome of patients treated with Gamma Knife radiosurgery (GKRS) for brain metastases from non-small cell lung cancer (NSCLC). Methods and Materials: Between 2001 and 2006, 373 patients (298 men and 75 women, median age 65 years) with brain metastases from NSCLC underwent GKRS. All of them had KPS {>=} 60%, eight or fewer brain metastases, confirmed histopathological diagnosis and recent work-up (<3 months). Thirty-five patients belonged to recursive partitioning analysis (RPA) Class I, 307 patients were in RPA Class II, 7 patients were in RPA Class III. Median tumor volume was 3.6 cm{sup 3}. Median marginal dose was 22.5 Gy at 50% isodose.; median 10 Gy and 12 Gy isodose volumes were 30.8 cm{sup 3} and 15.8 cm{sup 3}, respectively. Follow-up with MRI was performed every 3 months. Overall survival data were collected from internal database, telephone interviews, and identifying registries. Results: Mean follow-up after GKRS was 51 months (range, 6 to 96 months); mean overall survival was 14.2 months. Of 373 patients, 29 were alive at time of writing, 104 had died of cerebral progression, and 176 had died of systemic progression. In 64 cases it was not possible tomore » ascertain the cause. Univariate and multivariate analysis were adjusted for the following: RPA class, surgery, WBRT, age, gender, number of lesions, median tumor volume, median peripheral dose, and 10 Gy and 12 Gy volumes. Identified RPA class and overall tumor volume >5 cc were the only two covariates independently predictive of overall survival in patients who died of cerebral progression. Conclusions: Global volume of brain disease should be the main parameter to consider for performing GKRS, which is a first-line therapy for patient in good general condition and controlled systemic disease.« less

Authors:
 [1];  [2]; ;  [3];  [2];  [3]; ;  [1];  [2];  [3];  [1]
  1. Radiotherapy Department, San Raffaele Scientific Institute, Milan (Italy)
  2. Medical Physics Department, San Raffaele Scientific Institute, Milan (Italy)
  3. Neurosurgery Department, San Raffaele Scientific Institute, Milan (Italy)
Publication Date:
OSTI Identifier:
22054413
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 81; Journal Issue: 4; Other Information: Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRAIN; DIAGNOSIS; LUNGS; MEN; METASTASES; MULTIVARIATE ANALYSIS; NEOPLASMS; NMR IMAGING; PATIENTS; RADIATION DOSES; RADIOTHERAPY; SURGERY; WOMEN

Citation Formats

Motta, Micaela, E-mail: motta.micaela@hsr.it, Vecchio, Antonella del, Attuati, Luca, Picozzi, Piero, Perna, Lucia, Franzin, Alberto, Bolognesi, Angelo, Cozzarini, Cesare, Calandrino, Riccardo, Mortini, Pietro, and Muzio, Nadia di. Gamma Knife Radiosurgery for Treatment of Cerebral Metastases From Non-Small-Cell Lung Cancer. United States: N. p., 2011. Web. doi:10.1016/J.IJROBP.2011.02.051.
Motta, Micaela, E-mail: motta.micaela@hsr.it, Vecchio, Antonella del, Attuati, Luca, Picozzi, Piero, Perna, Lucia, Franzin, Alberto, Bolognesi, Angelo, Cozzarini, Cesare, Calandrino, Riccardo, Mortini, Pietro, & Muzio, Nadia di. Gamma Knife Radiosurgery for Treatment of Cerebral Metastases From Non-Small-Cell Lung Cancer. United States. doi:10.1016/J.IJROBP.2011.02.051.
Motta, Micaela, E-mail: motta.micaela@hsr.it, Vecchio, Antonella del, Attuati, Luca, Picozzi, Piero, Perna, Lucia, Franzin, Alberto, Bolognesi, Angelo, Cozzarini, Cesare, Calandrino, Riccardo, Mortini, Pietro, and Muzio, Nadia di. Tue . "Gamma Knife Radiosurgery for Treatment of Cerebral Metastases From Non-Small-Cell Lung Cancer". United States. doi:10.1016/J.IJROBP.2011.02.051.
@article{osti_22054413,
title = {Gamma Knife Radiosurgery for Treatment of Cerebral Metastases From Non-Small-Cell Lung Cancer},
author = {Motta, Micaela, E-mail: motta.micaela@hsr.it and Vecchio, Antonella del and Attuati, Luca and Picozzi, Piero and Perna, Lucia and Franzin, Alberto and Bolognesi, Angelo and Cozzarini, Cesare and Calandrino, Riccardo and Mortini, Pietro and Muzio, Nadia di},
abstractNote = {Purpose: To evaluate clinical and physico-dosimetric variables affecting clinical outcome of patients treated with Gamma Knife radiosurgery (GKRS) for brain metastases from non-small cell lung cancer (NSCLC). Methods and Materials: Between 2001 and 2006, 373 patients (298 men and 75 women, median age 65 years) with brain metastases from NSCLC underwent GKRS. All of them had KPS {>=} 60%, eight or fewer brain metastases, confirmed histopathological diagnosis and recent work-up (<3 months). Thirty-five patients belonged to recursive partitioning analysis (RPA) Class I, 307 patients were in RPA Class II, 7 patients were in RPA Class III. Median tumor volume was 3.6 cm{sup 3}. Median marginal dose was 22.5 Gy at 50% isodose.; median 10 Gy and 12 Gy isodose volumes were 30.8 cm{sup 3} and 15.8 cm{sup 3}, respectively. Follow-up with MRI was performed every 3 months. Overall survival data were collected from internal database, telephone interviews, and identifying registries. Results: Mean follow-up after GKRS was 51 months (range, 6 to 96 months); mean overall survival was 14.2 months. Of 373 patients, 29 were alive at time of writing, 104 had died of cerebral progression, and 176 had died of systemic progression. In 64 cases it was not possible to ascertain the cause. Univariate and multivariate analysis were adjusted for the following: RPA class, surgery, WBRT, age, gender, number of lesions, median tumor volume, median peripheral dose, and 10 Gy and 12 Gy volumes. Identified RPA class and overall tumor volume >5 cc were the only two covariates independently predictive of overall survival in patients who died of cerebral progression. Conclusions: Global volume of brain disease should be the main parameter to consider for performing GKRS, which is a first-line therapy for patient in good general condition and controlled systemic disease.},
doi = {10.1016/J.IJROBP.2011.02.051},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 81,
place = {United States},
year = {2011},
month = {11}
}