Journal article
Local Control and Survival Outcomes After Stereotactic Radiosurgery for Brain Metastases From Gastrointestinal Primaries: An International Multicenter Analysis
Neurosurgery, v 93(3), pp 592-598
Sep 2023
PMID: 36942965
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
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 & GE;2cc (P = .007) were associated with inferior LC. All factors other than dose were significant on multivariate analysis (P & LE; .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.
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- Title
- Local Control and Survival Outcomes After Stereotactic Radiosurgery for Brain Metastases From Gastrointestinal Primaries: An International Multicenter Analysis
- Creators
- Raj Singh - University Health SystemGreg Bowden - University of AlbertaDavid Mathieu - Université de SherbrookeHaley K. Perlow - The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research InstituteJoshua D. Palmer - The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research InstituteShahed Elhamdani - Allegheny Health NetworkMatthew Shepard - Allegheny Health NetworkYun Liang - Allegheny Health NetworkAhmed M. Nabeel - Nasser Institute hospitalWael A. Reda - Ain Shams UniversitySameh R. Tawadros - Ain Shams UniversityKhaled Abdelkarim - Ain Shams UniversityAmr M. N. El-Shehaby - Ain Shams UniversityReem M. Emad - Cairo UniversityAhmed Hesham Elazzazi - Ain Shams UniversityRonald E. Warnick - Jewish HospitalYair M. Gozal - Jewish HospitalMegan Daly - University of PennsylvaniaBrendan McShane - University of PennsylvaniaMarcel Addis-Jackson - University of PennsylvaniaGokul Karthikeyan - University of PennsylvaniaSian Smith - University of PennsylvaniaPiero Picozzi - IRCCS Humanitas Research HospitalAndrea Franzini - IRCCS Humanitas Research HospitalTehila Kaisman-Elbaz - Cleveland ClinicHuai-che Yang - Taipei Veteran Gen Hosp, Neurol Inst, Dept Neurosurg, Taipei, TaiwanZhishuo Wei - Neurological SurgeryAndrew Legarreta - University of PittsburghJudith Hess - Yale UniversityKelsey Templeton - Yale UniversityStylianos Pikis - University of VirginiaGeorgios Mantziaris - Neurological SurgeryGabriela Simonova - Na Homolce HospitalRoman Liscak - Na Homolce HospitalSelcuk Peker - Koç UniversityYavuz Samanci - Koç UniversityVeronica Chiang - Yale UniversityAjay Niranjan - University of PittsburghCharles R. Kersh - University of VirginiaCheng-Chia LeeDaniel M. Trifiletti - Mayo Clinic in FloridaL. Dade Lunsford - University of PittsburghJason P. Sheehan - Neurological Surgery
- Publication Details
- Neurosurgery, v 93(3), pp 592-598
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:001050079800028
- Scopus ID
- 2-s2.0-85162747671
- Other Identifier
- 991022155292504721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery