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Intracarotid Cancer Cell Injection to Produce Mouse Models of Brain Metastasis
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Brain Metastasis Growth Kinetics: A Novel Prognosticator for Stereotactic Radiotherapy.

S F Lee1, P L Yip1, O L Chan2

  • 1Department of Clinical Oncology, Tuen Mun Hospital, New Territories West Cluster, Hospital Authority, Hong Kong; Department of Radiation Oncology, National University Cancer Institute, National University Hospital, Singapore.

Clinical Oncology (Royal College of Radiologists (Great Britain))
|March 8, 2023
PubMed
Summary

Brain metastasis growth rate is a key predictor of survival in patients receiving stereotactic radiotherapy (SRT). A new model incorporating growth kinetics, extracranial disease, and neurological symptoms accurately predicts overall survival for brain metastasis patients undergoing SRT.

Keywords:
Brain metastaseslocal controlprognostic factorsstereotactic radiotherapysurvival

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Modeling Brain Metastases Through Intracranial Injection and Magnetic Resonance Imaging
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Area of Science:

  • Oncology
  • Radiotherapy
  • Medical Imaging

Background:

  • Brain metastases significantly impact patient prognosis.
  • Stereotactic radiotherapy (SRT) is a common treatment for brain metastases.
  • Understanding factors influencing survival after SRT is crucial for patient management.

Purpose of the Study:

  • To analyze the prognostic value of brain metastasis size kinetics in patients treated with linac-based SRT.
  • To develop a predictive model for overall survival in this patient population.

Main Methods:

  • Retrospective analysis of 85 patients treated with linac-based SRT between 2010 and 2020.
  • Assessment of brain metastasis size changes between diagnostic and stereotactic MRI.
  • Prognostic factor analysis using Cox regression with LASSO and bootstrap validation.

Main Results:

  • Brain metastasis growth kinetics (percentage change in size per day) was a significant predictor of overall survival (HR 1.32).
  • Extracranial oligometastatic disease (≤5 involvements) and presence of neurological symptoms were also significant prognostic factors.
  • The developed model demonstrated superior predictive accuracy (c-index 0.65) compared to existing scores (SIR 0.58, BS-BM 0.54).

Conclusions:

  • Brain metastasis growth kinetics is a valuable metric for predicting survival outcomes following SRT.
  • The proposed prognostic model effectively identifies patients with varying overall survival rates after SRT for brain metastases.