Pulmonary resection in patients with nonsmall-cell lung cancer treated with gamma-knife radiosurgery for synchronous brain metastases

Seung Yeob Yang, Gyu Kim Dong, Se Hoon Lee, Hyun Tai Chung, Ha Paek Sun, Hyun Kim Joo, Hee Won Jung, Hee Han Dae

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25 Scopus citations

Abstract

BACKGROUND. The aim of the current study was to determine whether a pulmonary resection and gamma-knife radiosurgery (GKRS) protocol is superior to GKRS alone in selected patients with stage IV nonsmall-cell lung cancer (NSCLC). METHODS. The authors performed a retrospective case-control study of 232 consecutive patients with newly diagnosed NSCLC from January 1998 to December 2005 and screened them to identify a study cohort in which all patients had thoracic stage I or II, Karnofsky performance status ≥70, no extracranial metastases, and 1-3 synchronous brain metastases of less than 3 cm, and were treated with GKRS (n = 31). The study cohort was divided into 2 groups, those with and without concomitant pulmonary resection. RESULTS. Sixteen patients with pulmonary resection were assigned to the treatment group and 15 without pulmonary resection were assigned to the control group. Median follow-up was 27.3 months (range, 4.4 months to 90.9 months). Mean survivals for the treatment group and the control group were 64.9 and 18.1 months, respectively (P < .001). There was a statistically significant association between pulmonary resection and better survival (OR = 78.408). One-year and 5-year local brain tumor control rates were 97.1% and 93.5%, respectively. CONCLUSIONS. The pulmonary resection and GKRS protocol could prolong survival in patients with thoracic stage I or II NSCLC, no extracranial metastases, and a limited number of small synchronous brain metastases.

Original languageEnglish
Pages (from-to)1780-1786
Number of pages7
JournalCancer
Volume112
Issue number8
DOIs
StatePublished - 15 Apr 2008

Keywords

  • Brain metastases
  • Gamma-knife radiosurgery
  • Lung cancer
  • Pulmonary resection

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