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Brain Metastases From Lung Adenocarcinoma May Preferentially Involve the Distal Middle Cerebral Artery Territory and Cerebellum

 Hyeokjin Kwon  ;  Jun Won Kim  ;  Mina Park  ;  Jin Woo Kim  ;  Minseo Kim  ;  Sang Hyun Suh  ;  Yoon Soo Chang  ;  Sung Jun Ahn  ;  Jong-Min Lee 
 FRONTIERS IN ONCOLOGY, Vol.10 : 1664, 2020-08 
Journal Title
Issue Date
adenocarcinoma ; arterial territory ; brain metastasis ; lung cancer ; spatial distribution
Although whole-brain radiation therapy (WBRT) is the mainstay of treatment for brain metastases (BMs), the concept of saving eloquent cortical lesions has been promoted. If BMs from lung cancer are spatially biased to certain regions, this approach can be justified more. We evaluated whether BMs from lung cancer show a preference for certain brain regions and if their distribution pattern differs according to the histologic subtype of the primary lung cancer. In this retrospective study, 562 BMs in 80 patients were analyzed (107 BMs from small cell carcinoma, 432 from adenocarcinoma, and 23 from squamous cell carcinoma). Kernel density estimation was performed to investigate whether BM spatial patterns differed among lung cancer subtypes. Further, we explored more detailed subregions where BMs from adenocarcinomas occur frequently using one-way analysis of variance. Finally, we divided our cohort into those with fewer (≤10) and more (>10) BMs and evaluated whether this biased pattern was maintained across limited and extensive stages. For small cell carcinoma, BMs were biased to the cerebellum, but this did not reach statistical significance. For adenocarcinoma, BMs were found more frequently near the distal middle cerebral artery (MCA) territory and cerebellum than in other arterial territories (p < 0.01). The precentral and postcentral gyri were the most significant subregions within the distal anterior cerebral artery (ACA) and MCA territories (p < 0.01). Crus I and Lobule VI were significant regions within the cerebellum (p < 0.01). Regardless of the number of BMs, the affinity to the distal MCA territory and cerebellum was maintained. The present data confirm that BMs from lung adenocarcinoma may preferentially involve the distal MCA territory and cerebellum.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jun Won(김준원) ORCID logo https://orcid.org/0000-0003-1358-364X
Kim, Jin Woo(김진우) ORCID logo https://orcid.org/0000-0003-3155-0569
Park, Mina(박미나) ORCID logo https://orcid.org/0000-0002-2005-7560
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
Ahn, Sung Jun(안성준) ORCID logo https://orcid.org/0000-0003-0075-2432
Chang, Yoon Soo(장윤수) ORCID logo https://orcid.org/0000-0003-3340-4223
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