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KMID : 0942820120110010038
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Journal of Korean Brain Tumor Society
2012 Volume.11 No. 1 p.38 ~ p.44
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Stereotactic Radiosurgery for Brain Metastases from Non-Small Cell Lung Cancer
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Lee Won-Seok
Kim Young-Hoon
Han Jung-Ho
Kim Chae-Yong
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Abstract
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Objectives: This study was performed to evaluate the therapeutic efficacy of stereotactic radiosurgery (SRS) for non-small cell lung cancer (NSCLC) brain metastases and to assess the associative factors for patients’ survival.
Methods: Seventy-three consecutive patients with 387 brain metastases from NSCLC were treated with SRS. The mean age of patients was 61.9±11.7 years (range, 34-84), and 44 (60.3%) patients were male. The mean number of tumors was 5.3±6.6 (range, 1-33). The mean tumor volume was 1.38±3.60 cm3 (range, 0.01-25.40), and the mean marginal radiation dose was 19.37 Gy±2.98 Gy (range, 7.00-25.00) at 53.91±8.32 % isodose line.
Results: The median overall survival (OS) after SRS was 17.2 months (95% CI, 7.3-27.1), and the actuarial OS rate 54.4 and 40.3% at the first and second year, respectively. In the multivariate analysis, the Karnofsky’s Performance Score was the only independent prognostic factor (HR=2.942 ; 95% CI, 1.337-6.476 ; p=0.007) for OS. Local control failure occurred in 17 patients (23.3%), and distant disease progression developed in 19 patients (26.0%) at a mean follow-up duration of 11.3±8.6 months. Neurological deficits and early tumor response (≤1 month) were significant prognostic factors for disease progression.
Conclusion: SRS was an effective treatment option for patients with brain metastases from NSCLC. Initial status of patients was the most important indicators for survival and disease progression after SRS for NSCLC brain metastases.
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KEYWORD
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Brain metastases, Karnofsky’s Performancescore, Neurological deficit, Non-small cell lung cancer, Stereotactic radiosurgery
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