open access

Vol 19, No 1 (2014)
Original research articles
Published online: 2014-01-01
Submitted: 2011-10-25
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Evaluation of results of linac-based radiosurgery for brain metastases from primary lung cancer

Dorota Jezierska, Krystyna Adamska, Włodzimierz Liebert
DOI: 10.1016/j.rpor.2013.06.006
·
Rep Pract Oncol Radiother 2014;19(1):19-29.

open access

Vol 19, No 1 (2014)
Original research articles
Published online: 2014-01-01
Submitted: 2011-10-25

Abstract

Aim

The purpose of our review was to evaluate results of radiosurgery for patients with brain metastases from lung cancer.

Background

Lung cancer is the leading cause of death from cancer and the most common source of brain metastases. Radiosurgery allows the precise focal delivery of a high single radiation dose to brain metastases and results in high rates of local control.

Materials and methods

83 patients were treated between 2006 and 2008. We evaluated local control and outcome after radiosurgery and identified prognostic factors.

Results

Median survival in the whole group was 7.8 months from radiosurgery and 11 months from diagnosis. Median survival in classes I, II and III was 13.2, 8.2 and 2.2 months. For 94% of patients symptoms improved or stabilised at the first follow-up visit and this status did not change during 7.1 months. According to the univariate analysis, factors associated with improved survival included: RPA class 1 compared with RPA 2 and 3, RPA class 2 compared with RPA 3, KPS[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]70, control of the primary disease, radiosurgery performed more than once, level of haemoglobin >7[[ce:hsp sp="0.25"/]]mmol/1, absence of extracranial metastases, volume of the biggest lesion <11[[ce:hsp sp="0.25"/]]cm3. The multivariate analysis confirmed a significant influence on survival for the following factors: RPA class 1 as compared with RPA 3, KPS[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]70, absence of extracranial metastases, multiplicity of radiosurgery.

Conclusions

Stereotactic radiosurgery is a safe and effective treatment. It proved to be effective and safe in older patients. Selection of patients who are likely to benefit most should be based on prognostic factors. KPS proved to be the most important prognostic factor. In the RPA III group (patients with KPS[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]70) survival time was similar to that achieved after symptomatic medical management.

Abstract

Aim

The purpose of our review was to evaluate results of radiosurgery for patients with brain metastases from lung cancer.

Background

Lung cancer is the leading cause of death from cancer and the most common source of brain metastases. Radiosurgery allows the precise focal delivery of a high single radiation dose to brain metastases and results in high rates of local control.

Materials and methods

83 patients were treated between 2006 and 2008. We evaluated local control and outcome after radiosurgery and identified prognostic factors.

Results

Median survival in the whole group was 7.8 months from radiosurgery and 11 months from diagnosis. Median survival in classes I, II and III was 13.2, 8.2 and 2.2 months. For 94% of patients symptoms improved or stabilised at the first follow-up visit and this status did not change during 7.1 months. According to the univariate analysis, factors associated with improved survival included: RPA class 1 compared with RPA 2 and 3, RPA class 2 compared with RPA 3, KPS[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]70, control of the primary disease, radiosurgery performed more than once, level of haemoglobin >7[[ce:hsp sp="0.25"/]]mmol/1, absence of extracranial metastases, volume of the biggest lesion <11[[ce:hsp sp="0.25"/]]cm3. The multivariate analysis confirmed a significant influence on survival for the following factors: RPA class 1 as compared with RPA 3, KPS[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]70, absence of extracranial metastases, multiplicity of radiosurgery.

Conclusions

Stereotactic radiosurgery is a safe and effective treatment. It proved to be effective and safe in older patients. Selection of patients who are likely to benefit most should be based on prognostic factors. KPS proved to be the most important prognostic factor. In the RPA III group (patients with KPS[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]70) survival time was similar to that achieved after symptomatic medical management.

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Keywords

Lung cancer; Radiosurgery; Brain metastasis; Prognostic factors

About this article
Title

Evaluation of results of linac-based radiosurgery for brain metastases from primary lung cancer

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 19, No 1 (2014)

Pages

19-29

Published online

2014-01-01

DOI

10.1016/j.rpor.2013.06.006

Bibliographic record

Rep Pract Oncol Radiother 2014;19(1):19-29.

Keywords

Lung cancer
Radiosurgery
Brain metastasis
Prognostic factors

Authors

Dorota Jezierska
Krystyna Adamska
Włodzimierz Liebert

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