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Local Control and Survival Outcomes After Stereotactic Radiosurgery for Brain Metastases From Gastrointestinal Primaries: An International Multicenter Analysis
R. Singh, G. Bowden, D. Mathieu, HK. Perlow, JD. Palmer, S. Elhamdani, M. Shepard, Y. Liang, AM. Nabeel, WA. Reda, SR. Tawadros, K. Abdelkarim, AMN. El-Shehaby, RM. Emad, AH. Elazzazi, RE. Warnick, YM. Gozal, M. Daly, B. McShane, M....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu multicentrická studie, časopisecké články
- MeSH
- analýza přežití MeSH
- dospělí MeSH
- Kaplanův-Meierův odhad MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory mozku * MeSH
- prognóza MeSH
- radiochirurgie * metody MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
BACKGROUND: There are limited data regarding outcomes for patients with gastrointestinal (GI) primaries and brain metastases treated with stereotactic radiosurgery (SRS). OBJECTIVE: To examine clinical outcomes after SRS for patients with brain metastases from GI primaries and evaluate potential prognostic factors. METHODS: The International Radiosurgery Research Foundation centers were queried for patients with brain metastases from GI primaries managed with SRS. Primary outcomes were local control (LC) and overall survival (OS). Kaplan-Meier analysis was used for univariate analysis (UVA) of prognostic factors. Factors significant on UVA were evaluated with a Cox multivariate analysis proportional hazards model. Logistic regressions were used to examine correlations with RN. RESULTS: We identified 263 eligible patients with 543 brain metastases. Common primary sites were rectal (31.2%), colon (31.2%), and esophagus (25.5%) with a median age of 61.6 years (range: 37-91.4 years) and a median Karnofsky performance status (KPS) of 90% (range: 40%-100%). One-year and 2-year LC rates were 83.5% (95% CI: 78.9%-87.1%) and 73.0% (95% CI: 66.4%-78.5%), respectively. On UVA, age >65 years ( P = .001), dose <20 Gy ( P = .006) for single-fraction plans, KPS <90% ( P < .001), and planning target volume ≥2cc ( P = .007) were associated with inferior LC. All factors other than dose were significant on multivariate analysis ( P ≤ .002). One-year and 2-year OS rates were 68.0% (95% CI: 61.5%-73.6%) and 31.2% (95% CI: 24.6%-37.9%), respectively. Age > 65 years ( P = .006), KPS <90% ( P = .005), and extracranial metastases ( P = .05) were associated with inferior OS. CONCLUSION: SRS resulted in comparable LC with common primaries. Age and KPS were associated with both LC and OS with planning target volume and extracranial metastases correlating with LC and OS, respectively. These factors should be considered in GI cancer patient selection for SRS.
Ain Shams University Cairo Egypt
Department of Clinical Oncology Ain Shams University Cairo Egypt
Department of Neurological Surgery University of Virginia Charlottesville Virginia USA
Department of Neurosurgery Ain Shams University Cairo Egypt
Department of Neurosurgery Allegheny Health Network Pittsburgh Pennsylvania USA
Department of Neurosurgery Benha University Banha Egypt
Department of Neurosurgery Gamma Knife Center Jewish Hospital Mayfield Clinic Cincinnati Ohio USA
Department of Neurosurgery Gamma Knife Center Nasser Institute Hospital Cairo Egypt
Department of Neurosurgery Humanitas Research Hospital IRCCS Rozzano Italy
Department of Neurosurgery Koc University School of Medicine Istanbul Turkey
Department of Neurosurgery National Yang Ming Chiao Tung University School of Medicine Taipei China
Department of Neurosurgery Neurological Institute Taipei Veteran General Hospital Taipei China
Department of Neurosurgery Université de Sherbrooke Sherbrooke Canada
Department of Neurosurgery University of Alberta Edmonton Canada
Department of Neurosurgery University of Pennsylvania Philadelphia Pennsylvania USA
Department of Neurosurgery Yale University School of Medicine New Haven Connecticut USA
Department of Radiation Oncology Allegheny Health Network Pittsburgh Pennsylvania USA
Department of Radiation Oncology Mayo Clinic Florida Jacksonville Florida USA
Department of Radiation Oncology National Cancer Institute Cairo University Giza City Egypt
Department of Radiation Oncology University of Virginia Charlottesville Virginia USA
Department of Stereotactic and Radiation Neurosurgery Na Homolce Hospital Prague Czechia
Citace poskytuje Crossref.org
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- $a Local Control and Survival Outcomes After Stereotactic Radiosurgery for Brain Metastases From Gastrointestinal Primaries: An International Multicenter Analysis / $c R. Singh, G. Bowden, D. Mathieu, HK. Perlow, JD. Palmer, S. Elhamdani, M. Shepard, Y. Liang, AM. Nabeel, WA. Reda, SR. Tawadros, K. Abdelkarim, AMN. El-Shehaby, RM. Emad, AH. Elazzazi, RE. Warnick, YM. Gozal, M. Daly, B. McShane, M. Addis-Jackson, G. Karthikeyan, S. Smith, P. Picozzi, A. Franzini, T. Kaisman-Elbaz, HC. Yang, Z. Wei, A. Legarreta, J. Hess, K. Templeton, S. Pikis, G. Mantziaris, G. Simonova, R. Liscak, S. Peker, Y. Samanci, V. Chiang, A. Niranjan, CR. Kersh, CC. Lee, DM. Trifiletti, LD. Lunsford, JP. Sheehan
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