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Open AccessArticle

Comparative Survival in Patients with Brain Metastases from Non-small-Cell Lung Cancer Treated before and after Implementation of Radiosurgery

1
Department of Oncology, McMaster University, Hamilton, ON, Canada
2
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2017, 24(2), 146-151; https://doi.org/10.3747/co.24.3420
Received: 2 January 2017 / Revised: 4 February 2017 / Accepted: 3 March 2017 / Published: 1 April 2017
Introduction: Survival after a diagnosis of brain metastasis in non-small-cell lung cancer (nsclc) is generally poor. We previously reported a median survival of approximately 4 months in a cohort of patients treated with whole-brain radiotherapy (wbrt). Since that time, we implemented a program of stereotactic radiosurgery (srs). In the present study, we examined survival and prognostic factors in a consecutive cohort of patients after the introduction of the srs program. Methods: Data from a retrospective review of 167 nsclc patients with brain metastasis referred to a tertiary cancer centre during 2010–2012 were compared with data from a prior cohort of 91 patients treated during 2005–2007 (“pre-srs cohort”). Results: Median overall survival from the date of diagnosis of brain metastasis (4.3 months in the srs cohort vs. 3.9 months in the pre-srs cohort, p = 0.74) was not significantly different in the cohorts. The result was similar when the no-treatment group was excluded from the srs cohort. Within the srs cohort only, significant differences is overall survival were observed between treatment groups (srs, wbrt plus srs, wbrt, and no treatment), with improved survival being observed on univariate and multivariate analysis for patients receiving srs compared with patients receiving wbrt alone (p < 0.001). Conclusions: No improvement in survival was observed for nsclc patients with brain metastases after the implementation of srs. Selected patients (younger age, female sex, good performance status, fewer brain metastases) treated with srs appeared to demonstrate improved survival. However, those observations might also reflect better patient selection for srs or a greater tendency to offer those patients systemic therapy in addition to srs.
Keywords: non-small-cell lung cancer; brain metastasis; radiosurgery; whole-brain radiotherapy; radiosurgery practice non-small-cell lung cancer; brain metastasis; radiosurgery; whole-brain radiotherapy; radiosurgery practice
MDPI and ACS Style

Greenspoon, J.N.; Ellis, P.M.; Pond, G.; Caetano, S.; Broomfield, J.; Swaminath, A. Comparative Survival in Patients with Brain Metastases from Non-small-Cell Lung Cancer Treated before and after Implementation of Radiosurgery. Curr. Oncol. 2017, 24, 146-151. https://doi.org/10.3747/co.24.3420

AMA Style

Greenspoon JN, Ellis PM, Pond G, Caetano S, Broomfield J, Swaminath A. Comparative Survival in Patients with Brain Metastases from Non-small-Cell Lung Cancer Treated before and after Implementation of Radiosurgery. Current Oncology. 2017; 24(2):146-151. https://doi.org/10.3747/co.24.3420

Chicago/Turabian Style

Greenspoon, J.N.; Ellis, P.M.; Pond, G.; Caetano, S.; Broomfield, J.; Swaminath, A. 2017. "Comparative Survival in Patients with Brain Metastases from Non-small-Cell Lung Cancer Treated before and after Implementation of Radiosurgery" Curr. Oncol. 24, no. 2: 146-151. https://doi.org/10.3747/co.24.3420

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