Abstract
We retrospectively evaluated the relationship between the response of lung lesions and distant progression-free survival (DPFS) after radiosurgery in patients with brain metastases. A total of 47 consecutive patients were treated with radiosurgery for brain metastases. Distant progression was defined as a new enhancing intracranial tumor or leptomeningeal enhancement noted on follow-up magnetic resonance imaging. Progression of lung lesions was defined as follows: (1) a 20% increase in the summed diameter of the target lesions; (2) an absolute increase of 5 mm when the summed diameter was very small; or (3) detection of new lesions in the lung. Distant progression after radiosurgery was observed for twenty-one (44.7%) patients; we observed development of new distant metastases in nine patients, development of leptomeningeal seeding in eight patients, and combined failure of distant progression and local control failure in four patients. Forty-two (89.4%) patients had lung lesions at the time of radiosurgery, and progression of their lung lesions during the post-radiosurgery follow-up period was observed for 18 (38.3%) of these. The median DPFS was 7.00 months (95% CI, 6.153–7.847). Actuarial DPFS 3, 6, and 12 months after radiosurgery was 81.5, 61.3, and 36.7%, respectively. In multivariate analysis, only the criterion progression of lung lesions reached statistical and independent significance (P = 0.021, OR = 3.372, 95% CI, 1.200–9.480). The response of lung lesions after radiosurgery is likely to be a good predictor of DPFS after radiosurgery in patients with brain metastases.
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Acknowledgments
This study was supported by Grant no. 11-2008-027 from the SNUBH Research fund. We would like to express our appreciation to Ji Young Park for her sincere help with this paper.
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Han, J.H., Kim, D.G., Oh, C.W. et al. Progression of the lung cancer primary correlates with the identification of new brain metastases after initial radiosurgery. J Neurooncol 106, 161–167 (2012). https://doi.org/10.1007/s11060-011-0653-y
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DOI: https://doi.org/10.1007/s11060-011-0653-y