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Predictive factors of early distant brain failure after gamma knife radiosurgery alone in patients with brain metastases of non-small-cell lung cancer

Authors
 Young Cheol Na  ;  Hyun Ho Jung  ;  Hye Ryun Kim  ;  Byoung Chul Cho  ;  Jin Woo Chang  ;  Yong Gou Park  ;  Won Seok Chang 
Citation
 JOURNAL OF NEURO-ONCOLOGY, Vol.132(2) : 333-340, 2017 
Journal Title
JOURNAL OF NEURO-ONCOLOGY
ISSN
 0167-594X 
Issue Date
2017
MeSH
Adult ; Aged ; Aged, 80 and over ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/radiotherapy* ; Brain Neoplasms/secondary* ; Carcinoma, Non-Small-Cell Lung/diagnostic imaging ; Carcinoma, Non-Small-Cell Lung/pathology* ; Female ; Humans ; Kaplan-Meier Estimate ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/pathology* ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Mutation/radiation effects ; Outcome Assessment (Health Care) ; Predictive Value of Tests ; Radiosurgery/adverse effects* ; Receptor, Epidermal Growth Factor/genetics ; Receptor, Epidermal Growth Factor/metabolism ; Retrospective Studies ; Young Adult
Keywords
Brain metastases ; Non-small cell lung cancer ; Predictive factor ; Radiosurgery
Abstract
The objective of this study was to elucidate the predictive factors for early distant brain failure in patients with brain metastases of non-small-cell lung cancer (NSCLC) who were treated with gamma knife radiosurgery (GKRS) without previous whole-brain radiotherapy (WBRT) or surgery. We retrospectively reviewed clinical and imaging data of 459 patients with brain metastases of NSCLC who underwent GKRS from June 2008 to December 2013. The primary end-point was early distant brain failure, defined as the detection of newly developed metastatic lesions on magnetic resonance imaging (MRI) 3 months after GKRS. Factors such as tumor pathology subtype, concurrent systemic chemotherapy, epidermal growth factor receptor (EGFR) mutation status, use of EGFR tyrosine kinase inhibitors (TKIs), systemic disease status, presence of a metastatic lesion only in delayed MRI, and volume and number of metastases were analyzed. There were no statistically significant differences with respect to pathologic subtype, concurrent systemic chemotherapy, EGFR mutation, and early distant brain failure. Patients treated with EGFR-TKIs (p = 0.004), with a stable systemic disease status (p = 0.028) and 3 or fewer brain lesions (p = 0.000) experienced a significantly lower incidence of early distant brain failure. This study suggests that GKRS alone could be considered for patients treated with EGFR-TKIs who have a stable systemic disease status and 3 or fewer brain lesions. WBRT should be considered for other patients.
Full Text
https://link.springer.com/article/10.1007%2Fs11060-017-2373-4
DOI
10.1007/s11060-017-2373-4
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hye Ryun(김혜련) ORCID logo https://orcid.org/0000-0002-1842-9070
Park, Yong Gou(박용구)
Chang, Won Seok(장원석) ORCID logo https://orcid.org/0000-0003-3145-4016
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
Jung, Hyun Ho(정현호)
Cho, Byoung Chul(조병철) ORCID logo https://orcid.org/0000-0002-5562-270X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160482
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