Files and links (1)
Published, Version of Record (VoR)Open Access (License Unspecified), Open
Journal article
Long-Term Survivorship Following Stereotactic Radiosurgery Alone for Brain Metastases: Risk of Intracranial Failure and Implications for Surveillance and Counseling
Neurosurgery, v 83(2), pp 203-209
Aug 2018
PMID: 28945873
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND: Historically, survival for even highly select cohorts of brain metastasis patients selected for SRS alone is <2 yr; thus, limited literature on risks of recurrence exists beyond 2 yr.
OBJECTIVE: To investigate the possibility that for subsets of patients the risk of intracranial failure beyond 2 yr is less than the commonly quoted 50% to 60%, wherein less frequent screening may be appropriate.
METHODS: As a part of our institutional radiosurgery database, we identified 132 patients treated initially with stereotactic radiosurgery (SRS) alone (+/- pre-SRS surgical resection) with at least 2 yr of survival and follow-up from SRS. Primary study endpoints were rates of actuarial intracranial progression beyond 2 yr, calculated using the Kaplan-Meier and Cox regression methods.
RESULTS: The median follow-up from the first course of SRS was 3.5 yr. Significant predictors of intracranial failure beyond 2 yr included intracranial failure before 2 yr (52% vs 25%, P < .01) and total SRS tumor volume >= 5 cc (51% vs 25%, P < .01). On parsimonious multivariate analysis, failure before 2 yr (HR = 2.2, 95% CI: 1.2-4.3, P = .01) and total SRS tumor volume >= 5 cc (HR = 2.3, 95% CI: 1.2-4.3, P = .01) remained significant predictors of intracranial relapse beyond 2 yr.
CONCLUSION: Relapse rates beyond 2 yr following SRS alone for brain metastases are low in patients who do not suffer intracranial relapse within the first 2 yr and with low-volume brain metastases, supporting a practice of less frequent screening beyond 2 yr. For remaining patients, frequent (every 3-4 mo) screening remains prudent, as the risk of intracranial failure after 2 yr remains high.
Metrics
Details
- Title
- Long-Term Survivorship Following Stereotactic Radiosurgery Alone for Brain Metastases: Risk of Intracranial Failure and Implications for Surveillance and Counseling
- Creators
- Emile Gogineni - UPMC Hillman Cancer CenterJohn A. Vargo - UPMC Hillman Cancer CenterScott M. Glaser - UPMC Hillman Cancer CenterJohn C. Flickinger - UPMC Hillman Cancer CenterSteven A. Burton - UPMC Hillman Cancer CenterJohnathan A. Engh - UPMC Hillman Cancer CenterNduka M. Amankulor - University of PittsburghSushil Beriwal - UPMC Hillman Cancer CenterAnette E. Quinn - UPMC Hillman Cancer CenterCihat Ozhasoglu - UPMC Hillman Cancer CenterDwight E. Heron - UPMC Hillman Cancer Center
- Publication Details
- Neurosurgery, v 83(2), pp 203-209
- Publisher
- Oxford Univ Press
- Number of pages
- 7
- Grant note
- U54 GM104942 / NIGMS NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of General Medical Sciences (NIGMS)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000454358800020
- Scopus ID
- 2-s2.0-85063624218
- Other Identifier
- 991021897278904721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Clinical Neurology
- Surgery