Your browser doesn't support javascript.
loading
Long term survivors of stereotactic radiosurgery for brain metastases: do distant brain failures reach a plateau and what factors are associated with a brain metastasis velocity of zero?
Lanier, Claire M; Pearce, Jane; Isom, Scott; Xing, Fei; Lo, Hui-Wen; Whitlow, Christopher T; Ruiz, Jimmy; White, Jaclyn J; Laxton, Adrian W; Tatter, Stephen B; Cramer, Christina K; Chan, Michael D.
Afiliação
  • Lanier CM; Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA. cmlanier@wakehealth.edu.
  • Pearce J; Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
  • Isom S; Department of Biostatistics, Wake Forest School of Medicine, Winston-Salem, NC, USA.
  • Xing F; Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
  • Lo HW; Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
  • Whitlow CT; Department of Biostatistics, Wake Forest School of Medicine, Winston-Salem, NC, USA.
  • Ruiz J; Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
  • White JJ; Department of Internal Medicine (Hematology & Oncology), Wake Forest School of Medicine, Winston-Salem, NC, USA.
  • Laxton AW; Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.
  • Tatter SB; Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.
  • Cramer CK; Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.
  • Chan MD; Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
J Neurooncol ; 160(3): 643-648, 2022 Dec.
Article em En | MEDLINE | ID: mdl-36335526
PURPOSE: Life expectancy continues to increase for patients with brain metastases treated with stereotactic radiosurgery (SRS). The present study sought to retrospectively analyze brain metastasis patients who have survived 2 years or more, and assess for what factors may predict for a final brain metastasis velocity (BMV) of zero. METHODS: This was a single-institution retrospective study of 300 patients treated with SRS from 2001 to 2019 for brain metastases who survived greater than 2 years after first SRS. Final BMV is calculated by summing all metastases through the observed time divided by the total time in years. A BMV of zero is defined as at least 2 years of imaging follow-up without distant brain failure (DBF). RESULTS: Median age at first SRS is 61 (IQR: 53, 70). Kaplan-Meier estimated median overall survival is 4.9 years and time to DBF is 1.5 years (95% CI 1.2, 2.0). Twenty-eight (9.3%) patients underwent subsequent WBRT. One hundred and one (33.7%) patients never had any further brain metastases (BMV = 0) at a median follow-up time of 3.3 years. Median BMV is 0.4 (IQR: 0, 1.4). Distant brain failures reach a plateau at 4 years where the cumulative incidence of DBF is 82%. 70% of first time DBFs have occurred by 2 years. Factors significantly associated with a BMV of zero include fewer brain metastases at first SRS (HR 1.1; p = 0.0004) and Caucasian race (HR 1.5; p = 0.03). CONCLUSION: Approximately one third of brain metastasis patients who live beyond 2 years after initial SRS have a BMV of zero. DBFs appear to reach a plateau at 4 years. Factors significantly associated with a BMV of zero include Caucasian race and having had a single brain metastasis at first SRS.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Encefálicas / Radiocirurgia Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Encefálicas / Radiocirurgia Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article