Oligo-recurrence predicts favorable prognosis of brain-only oligometastases in patients with non-small cell lung cancer treated with stereotactic radiosurgery or stereotactic radiotherapy: a multi-institutional study of 61 subjects

• Published in: BMC cancer Vol. 16; no. 1; p. 659
• Main Authors: Niibe, Yuzuru, Nishimura, Tetsuo, Inoue, Tetsuya, Karasawa, Katsuyuki, Shioyama, Yoshiyuki, Jingu, Keiichi, Shirato, Hiroki
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 19.08.2016; BioMed Central
• Subjects: Adult; Aged; Aged, 80 and over; Brain Neoplasms - radiotherapy; Brain Neoplasms - secondary; Carcinoma, Non-Small-Cell Lung - therapy; Care and treatment; Complications and side effects; Cranial Irradiation - methods; Diagnosis; Female; Humans; Lung cancer, Non-small cell; Lung Neoplasms - therapy; Male; Metastasis; Middle Aged; Multivariate Analysis; Prognosis; Radiosurgery; Radiosurgery - methods; Radiotherapy; Retrospective Studies; Survival Analysis; Treatment Outcome; Young Adult; Stereotactic radiosurgery (SRS); Stereotactic radiotherapy (SRT); Oligo-recurrence; Oligometastases; Non-small cell lung cancer (NSCLC)
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-016-2680-8

To investigate the prognostic value of oligo-recurrence in patients with brain-only oligometastases of non-small cell lung cancer (NSCLC) treated with stereotactic radiosurgery (SRS) or stereotactic radiotherapy (SRT). Patients treated with SRS or SRT for brain-only NSCLC oligometastases in 6 high-volume institutions in Japan between 1996 and 2008 were reviewed. Eligible patients met 1), 2), and 4) or 1), 3), and 4) of the following: 1) NSCLC with 1 to 4 brain metastases on magnetic resonance imaging (MRI) treated with SRS or SRT; 2) control of the primary lesions (thorax) at the time of SRS or SRT for brain metastases (patients meeting this criterion formed the oligo-recurrence group); 3) with SRS or SRT for brain metastases, concomitant treatment for active primary lesions (thorax) with curative surgery or curative stereotactic body radiotherapy (SBRT), or curative chemoradiotherapy (sync-oligometastases group); and 4) Karnofsky performance status (KPS) ≥70. The median overall survival (OS) of all 61 patients was 26 months (95 % CI: 17.5-34.5 months). The 2-year and 5-year overall survival rates were 60.7 and 15.7 %, respectively. Stratified by oligostatus, the sync-oligometastases group achieved a median OS of 18 months (95 % CI: 14.8-21.1 months) and a 5-year OS of 0 %, while the oligo-recurrence group achieved a median OS of 41 months (95 % CI: 27.8-54.2 months) and a 5-year OS of 18.6 %. On multivariate analysis, oligo-recurrence was the only significant independent factor related to a favorable prognosis (hazard ratio: 0.253 (95 % CI: 0.082-0.043) (p = 0.025). The presence of oligo-recurrence can predict a favorable prognosis of brain-only oligometastases in patients with NSCLC treated with SRS or SRT.