Journal of Korean Neurosurgical Society

  • 제50권2호
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  • Pages.99-102
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  • 2011
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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The Role of Radiosurgery in Patients with Brain Metastasis from Small Cell Lung Carcinoma

  • Jo, Kwang-Wook (Department of Neurosurgery, The Catholic University of Korea College of Medicine, Bucheon St. Mary's Hospital) ;
  • Kong, Doo-Sik (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lim, Do-Hoon (Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Ahn, Yong-Chan (Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Nam, Do-Hyun (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Jung-Il (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 투고 : 2011.03.10
  • 심사 : 2011.08.16
  • 발행 : 2011.08.28
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초록

Objective : The purpose of this retrospective study was to evaluate the outcome of gamma knife radiosurgery (GKRS) and/or whole brain radiation therapy (WBRT) for the treatment of small cell lung carcinoma (SCLC) metastasis to the brain. Methods : From 2000 to 2010, 50 patients underwent GKRS for metastatic brain lesions originating from SCLC. Among these patients, 11 received prophylactic cranial irradiation (PCI) before the development of metastatic lesions (PCI group), and GKRS was performed as an initial treatment for newly diagnosed lesions in 12 patients who had not received PCI (primary GKRS group). In addition, GKRS was performed as a salvage treatment for progressive lesions after WBRT in 27 patients (salvage GKRS group). The medical records and imaging data of all patients were retrospectively analyzed. Results : The overall survival of the 50 patients was 20.8 months (range 1-53) after the diagnosis of primary tumor and 12.0 months (range 1-47) after the development of cerebral metastasis. Median survival after GKRS was 4.8 months (range 1-15) in the PCI group, 4.6 months (range 0-18) in the primary GKRS group, and 7.6 months (range 0-33) in the salvage GKRS group. Further treatment for progressive lesions after GKRS was necessary in 15 patients, after a mean interval of 3.8 months. Causes of death were systemic organ failure in 15 patients, deterioration of neurological state in 13 patients, and unknown or combined causes in 16 patients. The local control rate of the lesions treated with GKRS was 76.4% (decreased in 13 patients and stable in 16 patients at the final imaging follow-up (mean 5.60 months). Conclusion : GKRS is an effective local treatment for brain metastasis from SCLC both as an initial treatment for newly diagnosed lesions after PCI and as a salvage treatment for recurrent or progressive lesions. However, the survival benefit is not significant because most patients die of systemic multi-organ failure with a short life expectancy.

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참고문헌

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  2. Strahlentherapeutische Optionen bei Hirnmetastasen des kleinzelligen Lungenkarzinoms vol.19, pp.11, 2011, https://doi.org/10.1007/s00761-013-2506-0
  3. Is stereotactic radiosurgery a rational treatment option for brain metastases from small cell lung cancer? A retrospective analysis of 70 consecutive patients vol.15, pp.None, 2011, https://doi.org/10.1186/s12885-015-1103-6
  4. Management of brain metastasis with magnetic resonance imaging and stereotactic irradiation attenuated benefits of prophylactic cranial irradiation in patients with limited-stage small cell lung cance vol.15, pp.None, 2015, https://doi.org/10.1186/s12885-015-1593-2
  5. The role of radiation therapy in the management of small cell lung cancer vol.13, pp.4, 2011, https://doi.org/10.1183/20734735.009617
  6. Strategies to Preserve Cognition in Patients With Brain Metastases: A Review vol.8, pp.None, 2011, https://doi.org/10.3389/fonc.2018.00415
  7. Outcomes of stereotactic radiosurgery of brain metastases from neuroendocrine tumors vol.5, pp.1, 2011, https://doi.org/10.1093/nop/npx009
  8. Evaluation of First-line Radiosurgery vs Whole-Brain Radiotherapy for Small Cell Lung Cancer Brain Metastases : The FIRE-SCLC Cohort Study vol.6, pp.7, 2011, https://doi.org/10.1001/jamaoncol.2020.1271
  9. Radiosurgery for Small-Cell Brain Metastases: Challenging the Last Bastion of Preferential Whole-Brain Radiotherapy Delivery vol.38, pp.31, 2011, https://doi.org/10.1200/jco.20.01823