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Journal of Neuro-Oncology

, Volume 144, Issue 1, pp 217–225 | Cite as

Primary or salvage stereotactic radiosurgery for brain metastatic small cell lung cancer

  • Andrew FaramandEmail author
  • Ajay Niranjan
  • Hideyuki Kano
  • John Flickinger
  • L. Dade Lunsford
Clinical Study

Abstract

Purpose

We evaluated the outcomes after stereotactic radiosurgery (SRS) for patients who developed new or progressive brain disease regardless of whether they had no prior radiation, PCI, or WBRT.

Methods

We retrospectively identified 90 SCLC patients who had SRS between 1991 and 2018. Thirty-one patients had no evidence of brain disease at the time of initial diagnosis but received prophylactic cranial irradiation. Twenty-six without initial brain disease underwent delayed SRS after brain disease was identified. Seventeen patients with synchronous systemic and brain disease underwent WBRT at the time of diagnosis. Fifteen patients had brain disease detected at the time of initial diagnosis and had initial SRS.

Results

We found no difference in overall survival between patients who received initial PCI or WBRT compared to patients treated with SRS alone at the time when brain metastases were identified. PCI was not associated with a longer duration between initial diagnosis and the development of brain metastasis. Local tumor control was achieved in 49 out of 58 patients who had follow up MRI available for review (84.5%). Actuarial local tumor control at 3, 6, and 12 months was calculated as 92%, 85%, and 80%, respectively. Radiation therapy (PCI or WBRT) before SRS was not associated with better or worse local tumor control.

Conclusion

In this experience neither prior PCI nor WBRT improved survival or local tumor control in SCLC patients who underwent SRS for new or recurrent brain disease.

Keywords

Lung cancer Radiation Radiosurgery Oncology 

Notes

Compliance with ethical standards

Conflict of interest

Dr. Lunsford is a consultant for and stockholder in Elekta AB.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Neurosurgery and Radiation OncologyUniversity of Pittsburgh Medical CenterPittsburghUSA
  2. 2.Department of Neurological SurgeryUniversity of PittsburghPittsburghUSA

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