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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Dosani M, Yang R, McLay M, Wilson D, Liu M, Yong-Hing CJ, Hamm J, Lund CR, Olson R, Schellenberg D. Metabolic tumour volume is prognostic in patients with non-small-cell lung cancer treated with stereotactic ablative radiotherapy. ACTA ACUST UNITED AC 2019; 26:e57-e63. [PMID: 30853810 DOI: 10.3747/co.26.4167] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction Stereotactic ablative radiotherapy (sabr) is a relatively new technique for the curative-intent treatment of patients with inoperable early-stage non-small-cell lung cancer (nsclc). Previous studies have demonstrated a prognostic value for positron emission tomography-computed tomography (pet/ct) parameters, including maximal standardized uptake value (suvmax), metabolic tumour volume (mtv), and total lesion glycolysis (tlg) in lung cancer patients. We aimed to determine which pet/ct parameter is most prognostic of local control (lc) and overall survival (os) in patients treated with sabr for nsclc. Methods We conducted a retrospective review of patients treated with sabr for stage I inoperable nsclc at BC Cancer between 2009 and 2013. The Akaike information criterion was used to compare the prognostic value of the various pet/ct parameters. Results The study included 134 patients with a median age of 76 years. Median tumour diameter was 2.2 cm, gross tumour volume was 8.1 mL, suvmax was 7.9, mtv was 2.4 mL, and tlg was 10.9 suv·mL. The 2-year lc was 92%, and os was 66%. On univariate and multivariate analysis, imaging variables including tumour size, gross tumour volume, suvmax, mtv, and tlg were all associated with worse lc. Tumour size was not associated with significantly worse os, but other imaging variables were. The pet/ct parameter most prognostic of lc was mtv. Compared with suvmax, tlg and mtv were more prognostic of os. Conclusions In patients with early-stage nsclc treated with sabr, mtv appears to be prognostic of lc and os.
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Affiliation(s)
- M Dosani
- Department of Radiation Oncology and Developmental Therapeutics, BC Cancer-Vancouver Centre, and Department of Surgery, Faculty of Medicine, Vancouver, BC
| | - R Yang
- Department of Radiation Oncology and Developmental Therapeutics, BC Cancer-Vancouver Centre, and Department of Surgery, Faculty of Medicine, Vancouver, BC
| | - M McLay
- Department of Radiation Oncology and Developmental Therapeutics, BC Cancer-Centre for the North, and Department of Surgery, Faculty of Medicine, Prince George, BC
| | - D Wilson
- Department of Functional Imaging, BC Cancer-Vancouver Centre, Vancouver, BC
| | - M Liu
- Department of Radiation Oncology and Developmental Therapeutics, BC Cancer-Vancouver Centre, and Department of Surgery, Faculty of Medicine, Vancouver, BC
| | - C J Yong-Hing
- Department of Radiology, BC Cancer-Vancouver Centre, and Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - J Hamm
- Cancer Surveillance and Outcomes, BC Cancer, Vancouver, BC
| | - C R Lund
- Department of Radiation Oncology and Developmental Therapeutics, BC Cancer-Fraser Valley Centre, Surrey, and Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - R Olson
- Department of Radiation Oncology and Developmental Therapeutics, BC Cancer-Centre for the North, and Department of Surgery, Faculty of Medicine, Prince George, BC
| | - D Schellenberg
- Department of Radiation Oncology and Developmental Therapeutics, BC Cancer-Fraser Valley Centre, Surrey, and Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC
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