Radiosurgery vs. Whole-Brain Radiation for Brain Metastases in Patients With Lung Cancer
Posted: Monday, January 22, 2018
Some patients with advanced non–small cell lung cancer (NSCLC) may benefit more from radiosurgery for multiple brain metastases than from whole-brain radiation therapy, according to an analysis published in the Journal of Thoracic Oncology. The patient subset featured in this study had advanced ALK- or EGFR-mutated disease and was treated with targeted therapies aimed at these genetic drivers.
“Despite the fact that patients on this study had multiple brain metastases, the outcomes were excellent with radiosurgery alone, with overall survival measured on the order of years,” added senior author Chad G. Rusthoven, MD, of the University of Colorado School of Medicine, in a press release. And, he noted, the lower doses of radiation to the normal brain may alter the risk of cognitive side effects.
After reviewing cases from the University of Colorado Cancer Center between 2008 and 2017, the investigators identified 35 patients with oncogene-addicted NSCLC who had four or more brain metastases and were treated in a single radiosurgery session. The median survival was 3 years (4.2 years for those with ALK-rearranged disease and 2.4 years for those with EGFR-mutated disease).
Although the number of brain metastases treated in a single session and the total number of overall treatment courses varied significantly, survival appeared to be equivalent. “Even when we treated over 10 brain metastases in 1 session, the dose to the whole brain was phenomenally lower than with whole-brain radiotherapy,” said lead author of the study Tyler P. Robin, MD, PhD, also of the University of Colorado.
