Journal article
A comparison of outcomes after radiosurgery in non-small cell lung cancer patients with one versus more than twenty brain metastases: an international multi-center study
Journal of neuro-oncology, v 174(3), pp 645-652
01 Sep 2025
PMID: 40459832
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Whether the number or cumulative volume of brain metastases affects survival in patients with metastatic non-small cell lung cancer (NSCLC) remains controversial. We conducted a volume matched multi-center study to determine whether patients with a single metastasis had better outcomes than patients with > 20 brain metastases.
Between 2014 and 2022, 317 NSCLC patients (21.14% female; single tumor: 278 patients; >20 tumors, 39 patients) underwent stereotactic radiosurgery (SRS). The prescribed margin dose, cumulative tumor volume, 12 Gy volume, and concurrent systematic disease managements were recorded. The overall survival (OS), local tumor control (LTC), adverse radiation effect (ARE) risk, and new tumor development were compared.
No difference in OS was found between patients with > 20 brain metastases and patients with a single metastasis (p = 0.61). Compared to the single tumor cohort, where 217 of 278 (78.06%) patients had no recorded local tumor progression, patients with > 20 brain metastases had a local tumor control rate of 76.92% (p = 0.25). Patients with > 20 tumors had a significantly higher rate of distant tumor development (69.2%) after SRS compared to patients with single tumors (35.3%; **p = 0.024). No significant difference of ARE rate was found.
In this volume matched multi-center study, patients with > 20 tumors showed comparable OS and LTC outcomes compared to patients with single tumors. The number of brain metastases should not be used as a criteria to exclude patients from receiving SRS.
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Details
- Title
- A comparison of outcomes after radiosurgery in non-small cell lung cancer patients with one versus more than twenty brain metastases: an international multi-center study
- Creators
- Chris Z Wei - University of Pittsburgh Medical CenterRegan Shanahan - Neurological SurgeryDavid Puccio - Neurological SurgeryHansen Deng - University of Pittsburgh Medical CenterCheng-Chia Lee - The Neurological InstituteHuai-Che Yang - The Neurological InstituteChristopher P Cifarelli - West Virginia UniversityJoshua D Hack - West Virginia UniversityDaniel T Cifarelli - West Virginia UniversitySelcuk Peker - Koç UniversityYavuz Samanci - Koç UniversityDavid Mathieu - Université de SherbrookeJocelyn Blanchard - Centre Hospitalier Universitaire de SherbrookeHaley K Perlow - The Ohio State University Wexner Medical CenterJoshua D Palmer - The Ohio State University Wexner Medical CenterManjul Tripathi - Post Graduate Institute of Medical Education and ResearchNuria Martínez Moreno - Hospital Ruber InternacionalRoberto Martínez Álvarez - Department of Neurosurgery and Gamma Knife Radiosurgery, Ruber Internacional Hospital, Madrid, SpainHerwin Speckter - Instituto Tecnológico de Santo DomingoWenceslao Hernandez - Instituto Tecnológico de Santo DomingoRoman Liščák - Na Homolce HospitalJaromir May - Na Homolce HospitalShahed Elhamdani - Allegheny Health NetworkMatthew J Shepard - Allegheny Health NetworkRodney Wegner - Allegheny Health NetworkConstantinos G Hadjipanayis - University of Pittsburgh Medical CenterL Dade Lunsford - Neurological SurgeryAjay Niranjan (Corresponding Author) - University of Pittsburgh Medical Center
- Publication Details
- Journal of neuro-oncology, v 174(3), pp 645-652
- Publisher
- Springer Nature
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:001502109800001
- Scopus ID
- 2-s2.0-105007141227
- Other Identifier
- 991022155295104721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Clinical Neurology
- Oncology