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Predictors of Survival After Stereotactic Radiosurgery for Untreated Single Non-Small Cell Lung Cancer Brain Metastases: 5- and 10-year Results.
Becco Neto, Eliseu; Chaves de Almeida Bastos, Dhiego; Telles, João Paulo Mota; Figueiredo, Eberval Gadelha; Teixeira, Manoel Jacobsen; de Assis de Souza Filho, Francisco; Prabhu, Sujit.
Afiliação
  • Becco Neto E; Division of Neurosurgery, Department of Neurology, University of São Paulo, São Paulo, São Paulo, Brazil.
  • Chaves de Almeida Bastos D; Neurosurgery Department, Cleveland Clinic, Cleveland, Ohio, USA.
  • Telles JPM; Division of Neurosurgery, Department of Neurology, University of São Paulo, São Paulo, São Paulo, Brazil.
  • Figueiredo EG; Division of Neurosurgery, Department of Neurology, University of São Paulo, São Paulo, São Paulo, Brazil. Electronic address: ebgadelha@yahoo.com.
  • Teixeira MJ; Division of Neurosurgery, Department of Neurology, University of São Paulo, São Paulo, São Paulo, Brazil.
  • de Assis de Souza Filho F; School of Engineering, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.
  • Prabhu S; Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
World Neurosurg ; 172: e447-e452, 2023 Apr.
Article em En | MEDLINE | ID: mdl-36682534
BACKGROUND: Stereotactic radiosurgery (SRS) presents as a good treatment option for smaller, deep-seated brain metastases (BMs). This study aims to determine predictors of SRS failure for patients with non-small cell lung cancer BMs. METHODS: This was a retrospective study of single non-small cell lung cancer BMs treated using SRS. We included patients >18 years with a single, previously untreated lesion. Primary outcome was treatment failure, defined as BMs dimension increase above the initial values. Demographic, clinical, and radiological data were collected to study potential predictors of treatment failure. RESULTS: Worse rates of progression-free survival (PFS) were associated with heterogeneous contrast enhancement (18.1 ± 4.1 vs. 41.9 ± 4 months; P < 0.001). Better rates of PFS were associated with volumes <1.06 cm3 (log-rank; P = 0.001). Graded prognostic assessment was significantly associated with survival at 120 months (log-rank; P < 0.001). Karnofsky Performance Scale was evaluated in 3 strata: 90-100, 80, and ≤70. Mean survival rates for these strata were 31.8 ± 3.9, 10.6 ± 2.2, and 9.8 ± 2.3 months, respectively (log-rank; P < 0.001). There were no differences regarding presence of extracranial metastases, age, or lesion location. A multivariable logistic regression found that volume <1.06 cm3 was associated with higher survival rates at 10 years (odds ratio: 3.2, 95% confidence interval: 1.3-8.0). CONCLUSIONS: Contrast-homogeneous metastases and lesions <1.06 cm3 are associated with better rates of PFS. Karnofsky Performance Scale and graded prognostic assessment were associated with more favorable survival rates after 10 years. Volume <1.06 cm3 was the only significant predictor of survival in the multivariable analysis.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Encefálicas / Radiocirurgia / Carcinoma Pulmonar de Células não Pequenas / Neoplasias Pulmonares Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: World Neurosurg Assunto da revista: NEUROCIRURGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Encefálicas / Radiocirurgia / Carcinoma Pulmonar de Células não Pequenas / Neoplasias Pulmonares Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: World Neurosurg Assunto da revista: NEUROCIRURGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos