Survival Outcomes of Local Compared With Systemic First Treatment of Non-Small Cell Lung Cancer Brain Metastases

ObjectiveThis retrospective study evaluated the survival advantage of local treatment targeted to brain metastases, relative to systemic therapy, as the first option for brain metastases of non-small cell lung cancer (NSCLC).MethodsFirst reviewed were 291 cases of NSCLC brain metastases from two cen...

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Autores principales:	Hong-Mei Liu, Chun-Liu Meng, Lu-Jun Zhao
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	brain metastases non-small cell lung cancer local treatment systemic treatment initiation of local treatment Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/1227e6a823a2417c9ed0c53333d4ab7b
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spelling	oai:doaj.org-article:1227e6a823a2417c9ed0c53333d4ab7b2021-11-10T05:35:45ZSurvival Outcomes of Local Compared With Systemic First Treatment of Non-Small Cell Lung Cancer Brain Metastases2234-943X10.3389/fonc.2021.706409https://doaj.org/article/1227e6a823a2417c9ed0c53333d4ab7b2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.706409/fullhttps://doaj.org/toc/2234-943XObjectiveThis retrospective study evaluated the survival advantage of local treatment targeted to brain metastases, relative to systemic therapy, as the first option for brain metastases of non-small cell lung cancer (NSCLC).MethodsFirst reviewed were 291 cases of NSCLC brain metastases from two centers. All patients were at least 18 years old, with histologically confirmed NSCLC, and required and underwent both local (radiotherapy or brain surgery) and systemic treatment (chemotherapy and tyrosine kinase inhibitor [TKI] medication). Demographics, clinical characteristics, and treatment-related variables were collected.ResultsThe final population comprised 160 patients. Overall, the multivariate analysis suggested that the following were associated with better survival: >3 cycles of chemotherapy; stereotactic radiosurgery; and TKI medication (all, P = 0.000). Local treatment that began within 1 week of the diagnosis of brain metastases was associated with poorer survival (P = 0.006). Among the 111 patients with symptomatic brain metastases, the multivariate analysis indicated that better survival was associated with >3 cycles of chemotherapy (P = 0.000), radiation dose >40 Gy (P = 0.001), stereotactic radiosurgery (P = 0.000), and TKI medication (P = 0.000), while local treatment that began within 1 week after the diagnosis of brain metastases was associated with poorer survival (P = 0.015).ConclusionsFor patients with NSCLC brain metastases, regardless of the presence of clinical symptoms associated with brain metastases, systemic treatment before local may be better for survival. Even when used to relieve clinical symptoms, local treatment should be within a setting of sufficient systemic treatment.Hong-Mei LiuHong-Mei LiuChun-Liu MengLu-Jun ZhaoFrontiers Media S.A.articlebrain metastasesnon-small cell lung cancerlocal treatmentsystemic treatmentinitiation of local treatmentNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	brain metastases non-small cell lung cancer local treatment systemic treatment initiation of local treatment Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	brain metastases non-small cell lung cancer local treatment systemic treatment initiation of local treatment Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Hong-Mei Liu Hong-Mei Liu Chun-Liu Meng Lu-Jun Zhao Survival Outcomes of Local Compared With Systemic First Treatment of Non-Small Cell Lung Cancer Brain Metastases
description	ObjectiveThis retrospective study evaluated the survival advantage of local treatment targeted to brain metastases, relative to systemic therapy, as the first option for brain metastases of non-small cell lung cancer (NSCLC).MethodsFirst reviewed were 291 cases of NSCLC brain metastases from two centers. All patients were at least 18 years old, with histologically confirmed NSCLC, and required and underwent both local (radiotherapy or brain surgery) and systemic treatment (chemotherapy and tyrosine kinase inhibitor [TKI] medication). Demographics, clinical characteristics, and treatment-related variables were collected.ResultsThe final population comprised 160 patients. Overall, the multivariate analysis suggested that the following were associated with better survival: >3 cycles of chemotherapy; stereotactic radiosurgery; and TKI medication (all, P = 0.000). Local treatment that began within 1 week of the diagnosis of brain metastases was associated with poorer survival (P = 0.006). Among the 111 patients with symptomatic brain metastases, the multivariate analysis indicated that better survival was associated with >3 cycles of chemotherapy (P = 0.000), radiation dose >40 Gy (P = 0.001), stereotactic radiosurgery (P = 0.000), and TKI medication (P = 0.000), while local treatment that began within 1 week after the diagnosis of brain metastases was associated with poorer survival (P = 0.015).ConclusionsFor patients with NSCLC brain metastases, regardless of the presence of clinical symptoms associated with brain metastases, systemic treatment before local may be better for survival. Even when used to relieve clinical symptoms, local treatment should be within a setting of sufficient systemic treatment.
format	article
author	Hong-Mei Liu Hong-Mei Liu Chun-Liu Meng Lu-Jun Zhao
author_facet	Hong-Mei Liu Hong-Mei Liu Chun-Liu Meng Lu-Jun Zhao
author_sort	Hong-Mei Liu
title	Survival Outcomes of Local Compared With Systemic First Treatment of Non-Small Cell Lung Cancer Brain Metastases
title_short	Survival Outcomes of Local Compared With Systemic First Treatment of Non-Small Cell Lung Cancer Brain Metastases
title_full	Survival Outcomes of Local Compared With Systemic First Treatment of Non-Small Cell Lung Cancer Brain Metastases
title_fullStr	Survival Outcomes of Local Compared With Systemic First Treatment of Non-Small Cell Lung Cancer Brain Metastases
title_full_unstemmed	Survival Outcomes of Local Compared With Systemic First Treatment of Non-Small Cell Lung Cancer Brain Metastases
title_sort	survival outcomes of local compared with systemic first treatment of non-small cell lung cancer brain metastases
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/1227e6a823a2417c9ed0c53333d4ab7b
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Survival Outcomes of Local Compared With Systemic First Treatment of Non-Small Cell Lung Cancer Brain Metastases

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