Objective: This study reports the results of stereotactic radiosurgery and fractionated stereotactic radiosurgery treatment for brain metastasis in non-small cell lung cancer patients treated with modern systemic treatment methods (immunotherapy, targeted agents, and current chemotherapy agents).
Material And Methods: This study retrospectively analyzed patients diagnosed with non-small cell lung cancer and brain metasta- ses who underwent stereotactic radiosurgery/fractionated stereotactic radiosurgery in the Radiation Oncology Clinic of Ankara Bilkent City Hospital between February 21, 2019, and August 15, 2022. The study's primary endpoint was accepted as the lesions' response sta- tus after stereotactic radiosurgery/fractionated stereotactic radiosurgery.The secondary endpoint was accepted as the patients' intracranial progression-free survival and overall survival.
Results: This study included 85 patients treated for 174 lesions. Their median follow-up was 6.6 (range: 1-42) months.Their median intracranial progression-free survival after radiotherapy was 5.3 (range: 1-33) months, and their median overall survival was 6.6 (range: 1-42) months. Concurrent immunotherapy was administered to 10 (11%) patients and targeted therapy to 8 (9%). Magnetic resonance imaging indicated that 14 (6%) patients had a complete response, 62 (35.6%) had a partial response, 10 (5.7%) had stable disease, and 23 (13.2%) had progressive disease. The complete response rate was significantly higher in patients receiving targeted therapy (P < .001; odds ratio = 0.0025, 95% CI = 0.006-0.109). Intracranial recurrence was observed in 28 (32.9%) patients after stereotactic radiosurgery/ fractionated stereotactic radiosurgery: 7 (8.2%) were inside the radiotherapy field, 13 (15.3%) were outside the radiotherapy field, and 8 (9.4%) overlapped the radiotherapy field. Intracranial progression-free survival was higher in patients receiving concomitant immu- notherapy (P = .028; hazard ratio = 0.107, 95% CI = 0.015-0.783). However, overall survival was higher in patients receiving targeted therapy (P = .035; hazard ratio = 0.217, 95% CI = 0.053-0.897).
Conclusion: Using current systemic agents with radiotherapy for brain metastasis significantly affected post-radiotherapy intracranial progression-free survival.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544484 | PMC |
| http://dx.doi.org/10.5152/ThoracResPract.2023.23025 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The Role of Radiotherapy in the Management of Melanoma Brain Metastases: An Overview.
Curr Treat Options Oncol
January 2025
Ella Lemelbaum Institute for Immuno Oncology, Chaim Sheba Medical Center, 6997801, Tel Aviv, Israel.
Clinical management of melanoma brain metastases is complex and requires multidisciplinary approach. With close collaboration between neurosurgeons, radiation oncologists and medical oncologists, melanoma patients with brain are offered different treatment modalities: surgery, radiation therapy, systemic therapy or combined treatments. Radiation therapy (whole brain radiotherapy- WBRT and stereotactic radiosurgery- SRS) is an integral part of treating melanoma brain metastases.
View Article and Find Full Text PDFIntroduction: Patients with metastatic renal cell carcinoma have a poor prognosis and its specific pathogenesis remains unelucidated.
Case Presentation: At 78 years of age, a Japanese male patient was diagnosed with metastatic renal cell carcinoma (cT3N2M1 stage) and multiple brain metastases that were responsive to stereotactic radiation therapy followed by systemic combination induction therapy of pembrolizumab plus lenvatinib. Adverse events, including grade 3 hypertension, grade 2 eruption, and elevated grade 2 fever, were controlled by a dose reduction or suspension of drugs.
Evidence-based clinical recommendations for hypofractionated radiotherapy: exploring efficacy and safety - Part 4: Liver and locally recurrent rectal cancer.
Radiat Oncol J
December 2024
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea.
In this paper, we review the use of hypofractionated radiotherapy for gastrointestinal malignancies, focusing on primary and metastatic liver cancer, and recurrent rectal cancer. Technological advancements in radiotherapy have facilitated the direct delivery of high-dose radiation to tumors, while limiting normal tissue exposure, supporting the use of hypofractionation. Hypofractionated radiotherapy is particularly effective for primary and metastatic liver cancer where high-dose irradiation is crucial to achieve effective local control.
View Article and Find Full Text PDFPreoperative versus postoperative stereotactic radiosurgery for brain metastases: a systematic review and meta-analysis of comparative studies.
Neurosurg Rev
January 2025
Department of Neurological Surgery, University of Virginia, Charlottesville, USA.
Resection is often the primary treatment for large brain tumors but is less practical for multiple brain metastases (BM). Current guidelines recommend stereotactic radiosurgery (SRS) for untreated BMs or following the surgical removal of a solitary BM to reduce the risk of local tumor recurrence. Preoperative SRS (pre-SRS) shows promise with fewer complications and more precise targeting, but it lacks tissue diagnosis and may hinder wound healing.
View Article and Find Full Text PDFTreatment Strategies for Intermediate Spinal Instability Neoplastic Score (SINS 7-12) Patients: A Systematic Review.
World Neurosurg
December 2024
Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA. Electronic address:
Background: The Spinal Instability Neoplastic Score (SINS) is used in determining instability in patients with spinal metastases. Intermediate scores of 7 to 12 suggest possible instability, but there are no clear guidelines to address patients with these scores.
Methods: We searched in PubMed, EMBASE, and Cochrane databases for studies that included patient demographics, tumor histology, surgical or radiotherapy management, and outcomes of patients with intermediate SINS.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!