Long-Term Survival in Patients With Synchronous, Solitary Brain Metastasis From Non-Small-Cell Lung Cancer Treated With Radiosurgery

Flannery, Todd W; Suntharalingam, Mohan; Regine, William F; Chin, Lawrence S; Krasna, Mark J; Shehata, Michael K; Edelman, Martin J; Kremer, Marnie; Patchell, Roy A; Kwok, Young

doi:10.1016/j.ijrobp.2007.12.031

Title: Long-Term Survival in Patients With Synchronous, Solitary Brain Metastasis From Non-Small-Cell Lung Cancer Treated With Radiosurgery

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Abstract

Purpose: 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). Patients and Methods: 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. Results: 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% (p < 0.0001). Median OS was significantly longer for patients with a KPS {>=}90 vs. KPS < 90 (27.8 months vs. 13.1 months, p < 0.0001). The prognostic factors significant on multivariate analysis were definitive thoracic therapy (p = 0.020) and KPS (p = 0.001). Conclusions: This is one ofmore »« less

Authors:

Flannery, Todd W; Suntharalingam, Mohan; Regine, William F ^[1]; Chin, Lawrence S ^[2]; Krasna, Mark J ^[3]; Shehata, Michael K ^[4]; Edelman, Martin J ^[5]; Kremer, Marnie ^[1]; Patchell, Roy A ^[6]; Kwok, Young ^[1]

Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD (United States)
Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD (United States)
Department of Thoracic Surgery, University of Maryland School of Medicine, Baltimore, MD (United States)
Department of Radiation Oncology, University of Kentucky School of Medicine, Lexington, KY (United States)
Department of Medical Oncology, University of Maryland School of Medicine, Baltimore, MD (United States)
Department of Neurosurgery, University of Kentucky School of Medicine, Lexington, KY (United States)

Publication Date:: Mon Sep 01 00:00:00 EDT 2008

OSTI Identifier:: 21124419

Resource Type:: Journal Article

Journal Name:: International Journal of Radiation Oncology, Biology and Physics

Additional Journal Information:: Journal Volume: 72; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2007.12.031; PII: S0360-3016(07)04771-2; Copyright (c) 2008 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; CARCINOMAS; CHEMOTHERAPY; LUNGS; METASTASES; MULTIVARIATE ANALYSIS; PATIENTS; RADIOTHERAPY; SURGERY

Citation Formats


                    Flannery, Todd W, Suntharalingam, Mohan, Regine, William F, Chin, Lawrence S, Krasna, Mark J, Shehata, Michael K, Edelman, Martin J, Kremer, Marnie, Patchell, Roy A, and Kwok, Young. Long-Term Survival in Patients With Synchronous, Solitary Brain Metastasis From Non-Small-Cell Lung Cancer Treated With Radiosurgery.  United States: N. p., 2008. 
        Web.  doi:10.1016/j.ijrobp.2007.12.031.

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                    Flannery, Todd W, Suntharalingam, Mohan, Regine, William F, Chin, Lawrence S, Krasna, Mark J, Shehata, Michael K, Edelman, Martin J, Kremer, Marnie, Patchell, Roy A, & Kwok, Young. Long-Term Survival in Patients With Synchronous, Solitary Brain Metastasis From Non-Small-Cell Lung Cancer Treated With Radiosurgery.  United States.  https://doi.org/10.1016/j.ijrobp.2007.12.031

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                    Flannery, Todd W, Suntharalingam, Mohan, Regine, William F, Chin, Lawrence S, Krasna, Mark J, Shehata, Michael K, Edelman, Martin J, Kremer, Marnie, Patchell, Roy A, and Kwok, Young. 2008.  
        "Long-Term Survival in Patients With Synchronous, Solitary Brain Metastasis From Non-Small-Cell Lung Cancer Treated With Radiosurgery".  United States.  https://doi.org/10.1016/j.ijrobp.2007.12.031.

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@article{osti_21124419,

  title        = {Long-Term Survival in Patients With Synchronous, Solitary Brain Metastasis From Non-Small-Cell Lung Cancer Treated With Radiosurgery},

  author       = {Flannery, Todd W and Suntharalingam, Mohan and Regine, William F and Chin, Lawrence S and Krasna, Mark J and Shehata, Michael K and Edelman, Martin J and Kremer, Marnie and Patchell, Roy A and Kwok, Young},

  abstractNote = {Purpose: 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). Patients and Methods: 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. Results: 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% (p < 0.0001). Median OS was significantly longer for patients with a KPS {>=}90 vs. KPS < 90 (27.8 months vs. 13.1 months, p < 0.0001). The prognostic factors significant on multivariate analysis were definitive thoracic therapy (p = 0.020) and KPS (p = 0.001). Conclusions: 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.},

  doi          = {10.1016/j.ijrobp.2007.12.031},

  url          = {https://www.osti.gov/biblio/21124419},
  journal      = {International Journal of Radiation Oncology, Biology and Physics},

  issn         = {0360-3016},

  number       = 1,

  volume       = 72,

  place        = {United States},

  year         = {Mon Sep 01 00:00:00 EDT 2008},

  month        = {Mon Sep 01 00:00:00 EDT 2008}

}

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