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KMID : 1038620150330030207
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Radiation Oncology Journal
2015 Volume.33 No. 3 p.207 ~ p.216
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Stereotactic radiosurgery for brain metastasis in non-small cell lung cancer
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Won Yong-Kyun
Ja Young Lee
Kang Young-Nam
Ji Sun-Jang
Kang Jin-Hyoung
Jung So-Lyoung
Sung Soo-Yoon
Jo In-Young
Park Hee-Hyun
Dong-Soo Lee
Chang Ji-Hyun
Lee Yun-Hee
Kim Yeon-Sil
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Abstract
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Purpose: Stereotactic radiosurgery (SRS) has been introduced for small-sized single and oligo-metastases in the brain. The aim of this study is to assess treatment outcome, efficacy, and prognostic variables associated with survival and intracranial recurrence.
Materials and Methods: This study retrospectively reviewed 123 targets in 64 patients with non-small cell lung cancer (NSCLC) treated with SRS between January 2006 and December 2012. Treatment responses were evaluated using magnetic resonance imaging. Overall survival (OS) and intracranial progression-free survival (IPFS) were determined.
Results: The median follow-up was 13.9 months. The median OS and IPFS were 14.1 and 8.9 months, respectively. Fifty-seven patients died during the follow-up period. The 5-year local control rate was achieved in 85% of 108 evaluated targets. The 1- and 2-year OS rates were 55% and 28%, respectively. On univariate analysis, primary disease control (p < 0.001), the Eastern Cooperative Oncology Group (ECOG) performance status (0-1 vs. 2; p = 0.002), recursive partitioning analysis class (1 vs. 2; p = 0.001), and age (<65 vs. ≥65 years; p = 0.036) were significant predictive factors for OS. Primary disease control (p = 0.041) and ECOG status (p = 0.017) were the significant prognostic factors for IPFS. Four patients experienced radiation necrosis.
Conclusion: SRS is a safe and effective local treatment for brain metastases in patients with NSCLC. Uncontrolled primary lung disease and ECOG status were significant predictors of OS and intracranial failure. SRS might be a tailored treatment option along with careful follow-up of the intracranial and primary lung disease status.
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KEYWORD
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Brain neoplasm, Neoplasm metastasis, Non-small-cell lung carcinoma, Radiosurgery, Prognosis
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