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Stereotactic Radiosurgery for Brain Metastases in Patients With Small Cell Lung Cancer
Victoria H Wang1, Badal Juneja2, Howard Warren Goldman3
1Cooper Medical School of Rowan University, Camden, New Jersey.
Advances in Radiation Oncology
|July 6, 2023
Summary
Stereotactic radiosurgery (SRS) offers acceptable control for small cell lung cancer (SCLC) brain metastases when fewer than 5 lesions are treated. Patients with more than 5 brain metastases (BM) experience high failure rates, suggesting SRS may not be ideal for them.
Area of Science:
- Oncology
- Neurology
- Radiotherapy
Background:
- Whole brain radiation therapy (WBRT) is the traditional treatment for small cell lung cancer (SCLC) with brain metastases.
- The efficacy of stereotactic radiosurgery (SRS) for these patients remains unclear.
Purpose of the Study:
- To evaluate the role and outcomes of SRS in patients with SCLC and brain metastases.
- To compare SRS effectiveness based on the number of brain metastases (BM) and prior WBRT.
Main Methods:
- Retrospective review of an SRS database.
- Analysis of 70 patients with SCLC and 337 treated BM.
- Assessment of patient outcomes including survival and central nervous system (CNS) control rates.
Main Results:
- Median survival was 4.9 months.
- Fewer BM correlated with improved overall survival (P < .021).
- 1-year CNS control rates were 39.2% for 1-2 BM, 27.6% for 3-5 BM, and 0% for >5 BM.
- Previous WBRT was associated with worse brain failure rates (P < .040).
Conclusions:
- SRS provides acceptable control for SCLC patients with fewer than 5 BM.
- Patients with >5 BM have high rates of subsequent brain failure and are not ideal candidates for SRS.
