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Karlsson AT, Hjermstad MJ, Aass N, Skovlund E, Kaasa S, Yri OE. Overall Survival after Radiotherapy for Brain Metastases According to ECOG Status-A Prospective Study of 294 NSCLC Patients. Cancers (Basel) 2024; 16:1486. [PMID: 38672568 PMCID: PMC11048345 DOI: 10.3390/cancers16081486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/04/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Up to 40% of non-smallcell lung cancer (NSCLC) patients develop brain metastases (BMs). The potential benefits of radiotherapy (RT) in patients with poor performance status (PS) are questionable, with considerable risk for futile treatment. We analyzed overall survival after initial radiotherapy in NSCLC patients with BMs, focusing on the relationship between PS and survival after RT. This study reports a prospective observational study including consecutive 294 NSCLC patients with first-time BMs. Overall survival (OS) was calculated from the start of RT to death or last follow-up (1 June 2023). Overall, in the 294 included patients (median age 69 years), the median OS was 4.6 months; 2.5 months after WBRT (n = 141), and 7.5 months after SRT (n = 153). After WBRT, mOS was equally poor for patients with ECOG 2 (1.9 months) and ECOG 3-4 (1.2 months). After SRT, mOS for patients with ECOG 2 was 4.1 months; for ECOG 3 patients, mOS was 4 1.6 months. For NSCLC patients with ECOG 2 diagnosed with BMs who are not candidates for surgery or SRT, WBRT should be questioned due to short survival.
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Affiliation(s)
- Astrid Telhaug Karlsson
- Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital (OUH), 0450 Oslo, Norway; (M.J.H.); (N.A.); (S.K.); (O.E.Y.)
- European Palliative Research Centre (PRC), Oslo University Hospital (OUH), 0450 Oslo, Norway
| | - Marianne Jensen Hjermstad
- Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital (OUH), 0450 Oslo, Norway; (M.J.H.); (N.A.); (S.K.); (O.E.Y.)
- European Palliative Research Centre (PRC), Oslo University Hospital (OUH), 0450 Oslo, Norway
| | - Nina Aass
- Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital (OUH), 0450 Oslo, Norway; (M.J.H.); (N.A.); (S.K.); (O.E.Y.)
- European Palliative Research Centre (PRC), Oslo University Hospital (OUH), 0450 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway
| | - Eva Skovlund
- Department of Public Health and Nursing, Faculty of Medicine and Health Services, NTNU—Norwegian University of Science and Technology, 7491 Trondheim, Norway;
| | - Stein Kaasa
- Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital (OUH), 0450 Oslo, Norway; (M.J.H.); (N.A.); (S.K.); (O.E.Y.)
- European Palliative Research Centre (PRC), Oslo University Hospital (OUH), 0450 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway
| | - Olav Erich Yri
- Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital (OUH), 0450 Oslo, Norway; (M.J.H.); (N.A.); (S.K.); (O.E.Y.)
- European Palliative Research Centre (PRC), Oslo University Hospital (OUH), 0450 Oslo, Norway
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Hudson K, Mondia MW, Zhang Y, Saha S, Gibert MK, Dube C, Sun Y, Marcinkiewicz P, Fadul C, Abounader R. The role of microRNAs in brain metastasis. J Neurooncol 2024; 166:231-241. [PMID: 38194195 PMCID: PMC10834572 DOI: 10.1007/s11060-023-04541-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/12/2023] [Indexed: 01/10/2024]
Abstract
Brain metastasis (BM) is the most common type of brain tumor and frequently foreshadows disease progression and poor overall survival with patients having a median survival of 6 months. 70,000 new cases of BM are diagnosed each year in the United States (US) and the incidence rate for BM is increasing with improved detection. MicroRNAs (miRNAs) are small non-coding RNAs that serve as critical regulators of gene expression and can act as powerful oncogenes and tumor suppressors. MiRNAs have been heavily implicated in cancer and proposed as biomarkers or therapeutic targets or agents. In this review, we summarize an extensive body of scientific work investigating the role of microRNAs in BM. We discuss miRNA dysregulation, functions, targets, and mechanisms of action in BM and present the current standing of miRNAs as biomarkers and potential therapeutics for BM. We conclude with future directions of miRNA basic and clinical research in BM.
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Affiliation(s)
- Kadie Hudson
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, VA, USA
| | - Mark Willy Mondia
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
| | - Ying Zhang
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, VA, USA
| | - Shekhar Saha
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, VA, USA
| | - Myron K Gibert
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, VA, USA
| | - Collin Dube
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, VA, USA
| | - Yunan Sun
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, VA, USA
| | - Pawel Marcinkiewicz
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, VA, USA
| | - Camilo Fadul
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
| | - Roger Abounader
- Department of Microbiology, Immunology, and Cancer Biology, Department of Neurology, University of Virginia, University of Virginia Cancer Center, Charlottesville, VA, USA.
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