Choice of radiotherapy modality for the combined treatment of non-small cell lung cancer with brain metastases: whole-brain radiation therapy with simultaneous integrated boost or stereotactic radiosurgery
PurposeTo compare Whole-brain radiation therapy with simultaneous integrated boost (WBRT+SIB) to stereotactic radiosurgery (SRS)for non-small cell lung cancer (NSCLC)with brain metastases (BMs)in terms of overall survival (OS), intracranial progression-free-survival(iPFS), toxicity and objective res...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-09-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1220047/full |
| _version_ | 1797676983086219264 |
|---|---|
| author | Xiaotao Dong Kunlun Wang Hui Yang Yan Li Yanqi Hou Jiali Chang Ling Yuan |
| author_facet | Xiaotao Dong Kunlun Wang Hui Yang Yan Li Yanqi Hou Jiali Chang Ling Yuan |
| author_sort | Xiaotao Dong |
| collection | DOAJ |
| description | PurposeTo compare Whole-brain radiation therapy with simultaneous integrated boost (WBRT+SIB) to stereotactic radiosurgery (SRS)for non-small cell lung cancer (NSCLC)with brain metastases (BMs)in terms of overall survival (OS), intracranial progression-free-survival(iPFS), toxicity and objective response rate (ORR)MethodsA retrospective review was performed in our hospital of 90 patients diagnosed with NSCLC- BM who received either SRS (n = 48) or WBRT+SIB (n = 42) from January 2016 to January 2022. 76 (84.44%) patients received systemic drug therapy after radiotherapy, including chemotherapy(n=53), targeted therapy(n=40), immunotherapy(n=23), and anti-vascular drug therapy(n=45). OS and iPFS were estimated by the Kaplan-Meier method and compared using the log-rank test. Univariate and Multivariate analysis of the prognostic factors was performed using the Cox proportional hazard regression model.ResultsThe WBRT+SIB cohort had a longer median iPFS (20.0 versus (VS) 12.0 months, P = 0.0069) and a similar median OS (32.0 vs 28.0 months, P = 0.195) than the SRS cohort. Intracranial objective response rates in WBRT +SIB and SRS cohorts were 76.19% and 70.09%, respectively (P = 0.566). Disease control rates were 88.09% and 83.33%, respectively (P = 0.521). Multivariate analysis showed that WBRT+SIB is the only factor affecting iPFS(hazard ratio (HR):0.597 {95%confidence interval(CI):0.370-0.966}, P=0.035). Sex, Liver metastasis and Lymph node metastasis are risk factors for NSCLC-BM.ConclusionIn the context of systemic drug therapy, WBRT+SIB may have better intracranial local control than SRS in NSCLC-BM patients. |
| first_indexed | 2024-03-11T22:38:21Z |
| format | Article |
| id | doaj.art-daf8c5bcebc84806b1f3a223bd19577a |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-11T22:38:21Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-daf8c5bcebc84806b1f3a223bd19577a2023-09-22T10:56:41ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-09-011310.3389/fonc.2023.12200471220047Choice of radiotherapy modality for the combined treatment of non-small cell lung cancer with brain metastases: whole-brain radiation therapy with simultaneous integrated boost or stereotactic radiosurgeryXiaotao DongKunlun WangHui YangYan LiYanqi HouJiali ChangLing YuanPurposeTo compare Whole-brain radiation therapy with simultaneous integrated boost (WBRT+SIB) to stereotactic radiosurgery (SRS)for non-small cell lung cancer (NSCLC)with brain metastases (BMs)in terms of overall survival (OS), intracranial progression-free-survival(iPFS), toxicity and objective response rate (ORR)MethodsA retrospective review was performed in our hospital of 90 patients diagnosed with NSCLC- BM who received either SRS (n = 48) or WBRT+SIB (n = 42) from January 2016 to January 2022. 76 (84.44%) patients received systemic drug therapy after radiotherapy, including chemotherapy(n=53), targeted therapy(n=40), immunotherapy(n=23), and anti-vascular drug therapy(n=45). OS and iPFS were estimated by the Kaplan-Meier method and compared using the log-rank test. Univariate and Multivariate analysis of the prognostic factors was performed using the Cox proportional hazard regression model.ResultsThe WBRT+SIB cohort had a longer median iPFS (20.0 versus (VS) 12.0 months, P = 0.0069) and a similar median OS (32.0 vs 28.0 months, P = 0.195) than the SRS cohort. Intracranial objective response rates in WBRT +SIB and SRS cohorts were 76.19% and 70.09%, respectively (P = 0.566). Disease control rates were 88.09% and 83.33%, respectively (P = 0.521). Multivariate analysis showed that WBRT+SIB is the only factor affecting iPFS(hazard ratio (HR):0.597 {95%confidence interval(CI):0.370-0.966}, P=0.035). Sex, Liver metastasis and Lymph node metastasis are risk factors for NSCLC-BM.ConclusionIn the context of systemic drug therapy, WBRT+SIB may have better intracranial local control than SRS in NSCLC-BM patients.https://www.frontiersin.org/articles/10.3389/fonc.2023.1220047/fullbrain metastasissimultaneous integrated booststereotactic radiosurgerynon-small cell lung cancercombined therapyradiotherapy |
| spellingShingle | Xiaotao Dong Kunlun Wang Hui Yang Yan Li Yanqi Hou Jiali Chang Ling Yuan Choice of radiotherapy modality for the combined treatment of non-small cell lung cancer with brain metastases: whole-brain radiation therapy with simultaneous integrated boost or stereotactic radiosurgery Frontiers in Oncology brain metastasis simultaneous integrated boost stereotactic radiosurgery non-small cell lung cancer combined therapy radiotherapy |
| title | Choice of radiotherapy modality for the combined treatment of non-small cell lung cancer with brain metastases: whole-brain radiation therapy with simultaneous integrated boost or stereotactic radiosurgery |
| title_full | Choice of radiotherapy modality for the combined treatment of non-small cell lung cancer with brain metastases: whole-brain radiation therapy with simultaneous integrated boost or stereotactic radiosurgery |
| title_fullStr | Choice of radiotherapy modality for the combined treatment of non-small cell lung cancer with brain metastases: whole-brain radiation therapy with simultaneous integrated boost or stereotactic radiosurgery |
| title_full_unstemmed | Choice of radiotherapy modality for the combined treatment of non-small cell lung cancer with brain metastases: whole-brain radiation therapy with simultaneous integrated boost or stereotactic radiosurgery |
| title_short | Choice of radiotherapy modality for the combined treatment of non-small cell lung cancer with brain metastases: whole-brain radiation therapy with simultaneous integrated boost or stereotactic radiosurgery |
| title_sort | choice of radiotherapy modality for the combined treatment of non small cell lung cancer with brain metastases whole brain radiation therapy with simultaneous integrated boost or stereotactic radiosurgery |
| topic | brain metastasis simultaneous integrated boost stereotactic radiosurgery non-small cell lung cancer combined therapy radiotherapy |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1220047/full |
| work_keys_str_mv | AT xiaotaodong choiceofradiotherapymodalityforthecombinedtreatmentofnonsmallcelllungcancerwithbrainmetastaseswholebrainradiationtherapywithsimultaneousintegratedboostorstereotacticradiosurgery AT kunlunwang choiceofradiotherapymodalityforthecombinedtreatmentofnonsmallcelllungcancerwithbrainmetastaseswholebrainradiationtherapywithsimultaneousintegratedboostorstereotacticradiosurgery AT huiyang choiceofradiotherapymodalityforthecombinedtreatmentofnonsmallcelllungcancerwithbrainmetastaseswholebrainradiationtherapywithsimultaneousintegratedboostorstereotacticradiosurgery AT yanli choiceofradiotherapymodalityforthecombinedtreatmentofnonsmallcelllungcancerwithbrainmetastaseswholebrainradiationtherapywithsimultaneousintegratedboostorstereotacticradiosurgery AT yanqihou choiceofradiotherapymodalityforthecombinedtreatmentofnonsmallcelllungcancerwithbrainmetastaseswholebrainradiationtherapywithsimultaneousintegratedboostorstereotacticradiosurgery AT jialichang choiceofradiotherapymodalityforthecombinedtreatmentofnonsmallcelllungcancerwithbrainmetastaseswholebrainradiationtherapywithsimultaneousintegratedboostorstereotacticradiosurgery AT lingyuan choiceofradiotherapymodalityforthecombinedtreatmentofnonsmallcelllungcancerwithbrainmetastaseswholebrainradiationtherapywithsimultaneousintegratedboostorstereotacticradiosurgery |