Retrospective evaluation of brain metastates in lung cancer patients treated with stereotactic radiosurgery alone

INTRODUCTION: Due to new systemic treatment modalities, overall survival in lung cancer is increasing. Incidence of brain metastases in lung cancer are more common for this reason. The utilisation of stereotactic radiosurgery for one and oligo (two-four) brain metastases, has provided this treatment strategy as a promt treatment alternative. In this study we aimed to investigate the efficiency of stereotactic radiosurgery in lung cancer patients with brain metastasis, the effectiveness of adding diffusion magnetic resonance imaging (MRI) to conventional MRI for treatment evaluation and the relationship between clinical parameters retrospectively.
METHODS: Seventy-nine lung cancer patients treated between January 2016 and December 2017 in our clinic with stereotactic radiosurgery whose eastern cooperative oncology group (ECOG) performance status were 0-1 and had less than 5 brain metastases, has retrsopectively analysed.
RESULTS: The median age of patients was 59 years (43-78). Diffusion MRI has provided no more benefit for evaluation of treatment. There was no statistically significant mortality difference between subgroups of small cell and non small cell lung carcinoma. The presence of extracranial metastases has shortened the overall survival time significantly (p=0,042).
DISCUSSION AND CONCLUSION: The lung cancer patients with brain metastases have histopathological and genetic heterogenity. Multivariate analysis showed the presence of extracranial metastases had only unfavorable impact on overall survival in our study.

Akciðer kanserine sekonder beyin metastazlarýnda sadece stereotaktik radyocerrahi uygulanan olgularýn retrospektif deðerlendirilmesi

GÝRÝÞ ve AMAÇ: Akciðer kanserinde geliþen sistemik tedavi seçenekleri nedeniyle yaþam süresi uzamakta ve bu nedenle beyin metastazý insidansý da giderek artýþ göstermektedir. Stereotaktik radyocerrahinin tek ve oligo (iki-dört adet) beyin metastazý tedavisinde kullanýlmaya baþlanmasý bu konuda hýzlý bir tedavi alternatifi olmasýný saðlamýþtýr. Takip ettiðimiz akciðer kanserine baðlý beyin metastazlý olgularda retrospektif olarak stereotaktik radyocerrahi tedavisi etkinliðini, stereotaktik radyocerrahi tedavisine yanýtýn difüzyon manyetik rezonans görüntüleme (MRG) ile deðerlendirmenin konvansiyonel MRG’ye ek yararýný ve klinik parametreler arasý iliþkileri deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Kliniðimizde akciðer kanseri tanýsý ile takip edilen, Batý Kooperatif Onkoloji Grubu (ECOG) performans statüleri 0-1 ve 1-4 arasý beyin metastazý olan, Ocak 2016 – Aralýk 2017 tarihleri arasýnda stereotaktik radyocerrahi gören 79 olgunun verileri retrospektif olarak incelendi.
BULGULAR: Hastalarýn medyan taný yaþý 59 yýl (43-78) bulundu. Difüzyon MRG’nin tedavi yanýtýný deðerlendirmede ek yararý saptanmadý. Küçük hücreli ve küçük hücreli dýþý akciðer kanseri alt gruplarýnda istatistiksel anlamlý mortalite farký görülmemiþtir. Beyin dýþý diðer organlara metastaz varlýðý tüm sað kalým süresini azaltmýþ ve istatistiksel olarak anlamlý bulunmuþtur (p=0,042).
TARTIÞMA ve SONUÇ: Akciðer kanserine baðlý geliþen beyin metastazlý olgular genetik ve histopatolojik olarak heterojen bir hasta grubundan oluþmaktadýr. Çalýþmamýzda, sadece stereotaktik radyocerrahi uygulanan olgularda, çok deðiþkenli analiz sonucu beyin metastazý dýþý metastaz varlýðýnýn tüm sað kalým süresini olumsuz etkilediðini göstermiþtir.