Premium
Pulmonary resection in patients with nonsmall‐cell lung cancer treated with gamma‐knife radiosurgery for synchronous brain metastases
Author(s) -
Yang SeungYeob,
Kim Dong Gyu,
Lee SeHoon,
Chung HyunTai,
Paek Sun Ha,
Hyun Kim Joo,
Jung HeeWon,
Han Dae Hee
Publication year - 2008
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.23357
Subject(s) - medicine , radiosurgery , concomitant , lung cancer , surgery , stage (stratigraphy) , retrospective cohort study , cohort , cancer , radiation therapy , paleontology , biology
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. Cancer 2008. © 2008 American Cancer Society.