Scholarlink

Background <p>Whether the number or cumulative volume of brain metastases affects survival in patients with metastatic non-small cell lung cancer (NSCLC) remains controversial. We conducted a volume matched multi-center study to determine whether patients with a single metastasis had better outcomes than patients with &gt; 20 brain metastases.</p> Methods <p>Between 2014 and 2022, 317 NSCLC patients (21.14% female; single tumor: 278 patients; &gt;20 tumors, 39 patients) underwent stereotactic radiosurgery (SRS). The prescribed margin dose, cumulative tumor volume, 12&#xa0;Gy volume, and concurrent systematic disease managements were recorded. The overall survival (OS), local tumor control (LTC), adverse radiation effect (ARE) risk, and new tumor development were compared.</p> Results <p>No difference in OS was found between patients with &gt; 20 brain metastases and patients with a single metastasis (<i>p</i> = 0.61). Compared to the single tumor cohort, where 217 of 278 (78.06%) patients had no recorded local tumor progression, patients with &gt; 20 brain metastases had a local tumor control rate of 76.92% (<i>p</i> = 0.25). Patients with &gt; 20 tumors had a significantly higher rate of distant tumor development (69.2%) after SRS compared to patients with single tumors (35.3%; **<i>p</i> = 0.024). No significant difference of ARE rate was found.</p> Conclusion <p>In this volume matched multi-center study, patients with &gt; 20 tumors showed comparable OS and LTC outcomes compared to patients with single tumors. The number of brain metastases should not be used as a criteria to exclude patients from receiving SRS.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

A comparison of outcomes after radiosurgery in non-small cell lung cancer patients with one versus more than twenty brain metastases: an international multi-center study

  • 期刊论文

  • 发表日期：

    2025年6月3日

查看全文
  • Chris Z. Wei,
  • Regan Shanahan,
  • David Puccio,
  • Hansen Deng,
  • Cheng-Chia Lee,
  • Huai-Che Yang,
  • Christopher P. Cifarelli,
  • Joshua D. Hack,
  • Daniel T. Cifarelli,
  • Selcuk Peker,
  • Yavuz Samanci,
  • David Mathieu,
  • Jocelyn Blanchard,
  • Haley K. Perlow,
  • Joshua D. Palmer,
  • Manjul Tripathi,
  • Nuria Martínez Moreno,
  • Roberto Martínez Álvarez,
  • Herwin Speckter,
  • Wenceslao Hernandez,
  • Roman Liščák,
  • Jaromir May,
  • Shahed Elhamdani,
  • Matthew J. Shepard,
  • Rodney Wegner,
  • Constantinos G. Hadjipanayis,
  • L. Dade Lunsford,
  • Ajay Niranjan

摘要

Background

Whether the number or cumulative volume of brain metastases affects survival in patients with metastatic non-small cell lung cancer (NSCLC) remains controversial. We conducted a volume matched multi-center study to determine whether patients with a single metastasis had better outcomes than patients with > 20 brain metastases.

Methods

Between 2014 and 2022, 317 NSCLC patients (21.14% female; single tumor: 278 patients; >20 tumors, 39 patients) underwent stereotactic radiosurgery (SRS). The prescribed margin dose, cumulative tumor volume, 12 Gy volume, and concurrent systematic disease managements were recorded. The overall survival (OS), local tumor control (LTC), adverse radiation effect (ARE) risk, and new tumor development were compared.

Results

No difference in OS was found between patients with > 20 brain metastases and patients with a single metastasis (p = 0.61). Compared to the single tumor cohort, where 217 of 278 (78.06%) patients had no recorded local tumor progression, patients with > 20 brain metastases had a local tumor control rate of 76.92% (p = 0.25). Patients with > 20 tumors had a significantly higher rate of distant tumor development (69.2%) after SRS compared to patients with single tumors (35.3%; **p = 0.024). No significant difference of ARE rate was found.

Conclusion

In this volume matched multi-center study, patients with > 20 tumors showed comparable OS and LTC outcomes compared to patients with single tumors. The number of brain metastases should not be used as a criteria to exclude patients from receiving SRS.