156P - Clinical outcome of cyberknife radiosurgery in brain metastases of non-small cell lung cancer: A single institutional experience

Date 07 May 2017
Event ELCC 2017
Session Poster Display Session
Topics Non-Small-Cell Lung Cancer, Metastatic
Lung and other Thoracic Tumours
Surgery and/or Radiotherapy of Cancer
Presenter Sea-Won Lee
Citation Annals of Oncology (2017) 28 (suppl_2): ii52-ii55. 10.1093/annonc/mdx094
Authors S. Lee1, Y. Kim1, Y.K. Won1, S.J. Lee1, J.H. Hong1, Y.N. Kang1, J.H. Kang2, S. Hong2, S.J. Kim3, Y.K. Kim3
  • 1Department Of Radiation Oncology, Seoul St. Mary's Hospital, of the Catholic University, 06591 - Seoul/KR
  • 2Department Of Medical Oncology, Seoul St. Mary's Hospital, of the Catholic University, 06591 - Seoul/KR
  • 3Department Of Pulmonology, Seoul St. Mary's Hospital, of the Catholic University, 06591 - Seoul/KR

Abstract

Background

Stereotactic radiosurgery is a less invasive therapeutic modality for brain metastasis of non-small cell lung cancer (NSCLC). We retrospectively reviewed a single institutional experience using Cyberknife radiosurgery (CKRS).

Methods

The patients diagnosed with brain metastasis of NSCLC who were treated with CK-RS from 2006 to 2016 in Seoul St. Mary’s Hospital were analyzed. Total 304 targets from 150 patients were included. The histology of NSCLC patients was as follows: adenocarcinoma (85%), squamous cell carcinoma (9%), and others (7%). Median 22 Gy (range: 17-30Gy, 1-8 fx) was given. Median 2 targets (range: 1-7 targets) were treated per patient. Whole brain radiotherapy (WBRT) was given to 44.7% of the patients. Total 68 patients (45.5%) were mutation positive and targeted therapy was given to 95 patients (63.3%).

Results

Median follow-up time was 11.4 mo (range: 0-94.6 mo) from the last day of CKRS. Response to CKRS was observed in 86.1% of the targets. Median time to response was 2.9 mo (range: 0.2-58.8 mo). At the time of analysis, there were 14 recurrences (4.6%) and median time to recurrence was 13.3 mo (range: 4.1-62.6 mo). Intracranial failure defined as appearance of new metastasis other than sites previously treated with CKRS was observed in 81 patients (54.7%) at median 8.9 mo (range: 7-10.8 mo). The 1-year intracranial failure rates of the patients who received targeted therapy were 64.8% versus 55.3% of those who did not, respectively (P = 0.38). The 1-year intracranial failure rates of the patients who received CKRS alone were 64% versus 58.3% of those who received both CKRS and WBRT, respectively (P = 0.58). Radiation-associated change on MRI was observed in 98 targets (32.3%) at median 7.0 mo (range: 0.4-68.8 mo). Eleven patients (7.3%) required steroids for symptom alleviation at median 21 days (range: 7-42 days). Five patients (3.0%) underwent surgery after median 7.0 mo (range: 2.8-74.2 mo). The patients survived median 12.6 mo (range: 0.3-94.8 mo) after CKRS.

Conclusions

According to our institutional experience, CKRS achieved adequate local control with tolerable toxicity in patients with brain metastasis of NSCLC.

Clinical trial identification

Legal entity responsible for the study

The institutional review board reviewed and approved of the study.

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.