Multi-institutional retrospective review of stereotactic radiosurgery for brain metastasis in patients with small-cell lung cancer without prior brain-directed radiotherapy
Joseph A. Miccio, Andrew Barsky, Sarah Gao, Vivek Verma, Sonal S. Noticewala, Vikram Jairam, Skyler B. Johnson, James B. Yu, James E. Hansen, Sanjay Aneja, Yi An, Roy H. Decker, S. Bulent Omay, Jing Li, Goldie A. Kurtz, Michelle Alonso-Basanta, John Y.K. Lee, Veronica L. Chiang and Henry S. Park
Introduction: Patients with small cell lung cancer (SCLC) brain metastasis (BM) typically receive whole brain radiotherapy (WBRT) as data regarding upfront radiosurgery (SRS) in this setting are sparse.
Methods: Patients receiving SRS for SCLC BM without prior brain radiation were identified at three U.S. institutions. Overall survival (OS), freedom from intracranial progression (FFIP), freedom from WBRT (FFWBRT), and freedom from neurologic death (FFND) were determined from time of SRS.
Results: Thirty-three patients were included with a median of 2 BM (IQR 1-6). Median OS and FFIP were 6.7 and 5.8 months, respectively. Median FFIP for patients with ≤2 versus >2 BM was 7.1 versus 3.6 months, p=0.0303. Eight patients received salvage WBRT and the 6-month FFWBRT and FFND were 87.8%. and 90.1%, respectively.
Conclusions: Most SCLC patients with BM who received upfront SRS avoided WBRT and neurologic death, suggesting that SRS may be an option in select patients.
Keywords: Stereotactic radiosurgery, small cell lung cancer, brain metastasis, survival