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nsclc brain radiotherapy

Hideoki Yokouchi, Masaki Miyazaki, Takeaki Miyamoto, Takafumi Minami, Fumio Tsuji, Kazuhito Oishi, Chikara Ebisui
Four patients with non-small-cell lung cancer(NSCLC), diagnosed with cN2 stage III A disease, by using CT and FDG-PET/ CT imaging, received 2 or 3 courses of platinum-based combination chemotherapy.The patients achieved partial response after chemotherapy and underwent surgery.Complete tumor resection was performed via upper lobectomy for 3 patients, but in 1 patient, interlobar metastatic lymph nodes remained after middle and lower bilobectomy.Two courses of postoperative chemotherapy were administered to 3 patients, but 1 patient could not receive postoperative chemotherapy due to complications...
April 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
SooYoon Sung, Sea-Won Lee, Yoo-Kang Kwak, Jin Hyung Kang, Sook Hee Hong, Yeon-Sil Kim
INTRODUCTION: The efficacy of tyrosine kinase inhibitors (TKIs) with and without radiotherapy (RT) has not been determined in patients with brain metastases from epidermal growth factor receptor-mutant TKI naïve non-small cell lung cancer (NSCLC). METHODS: Between 2008 and 2016, 586 patients were diagnosed with NSCLC and treated with TKIs at a hospital in Seoul, South Korea; 81 of these patients met the eligibility criteria for our study. Outcomes analyzed included intracranial progression (ICP), neurological death, and overall survival (OS)...
April 11, 2018: Journal of Neuro-oncology
Cornelia Nitipir, Octav Ginghina, Liliana Popa, Florin Andrei, Nicolaie Tudor, Irina Radu, Cristian Iaciu, Cristina Orlov, Florina Vasilescu, Cristian Balalau, Grigoris Leon, Carolina Negrei, Maria Alexandra Barbu
Although gastric metastases have been estimated to occur in less than 2% of cancer patients, an increased use of upper digestive tract endoscopy allows for a higher detection of secondary gastric tumors. We describe the case of a 66-year-old male patient presenting with mild pain in the sternum and upper abdominal area. Physical examination revealed a right parietal skull tumor, with no other significant clinical changes. Upon exclusion of an acute coronary syndrome, upper digestive tract endoscopy was performed, showing the presence of an ulcerated tumor located in the gastric fundus...
April 2018: Molecular and Clinical Oncology
Yong Xin, WenWen Guo, Chun Sheng Yang, Qian Huang, Pei Zhang, Long Zhen Zhang, Guan Jiang
The aim of this meta-analysis was to compare the efficiency of whole-brain radiotherapy (WBRT) plus temozolomide (TMZ) with WBRT for the treatment of brain metastases from non-small-cell lung cancer (NSCLC). For dichotomous variables, outcomes were reported as relative risk ratio (RR) and 95% confidence interval (CI) was used to investigate the following outcome measures: overall response rate, headache, gastrointestinal adverse reactions, and hematological adverse reactions. Twelve randomized controlled trials involving 925 participants (480 received WBRT plus TMZ; 445 received WBRT) were included in the meta-analysis...
March 7, 2018: Cancer Medicine
Bilgehan Sahin, Teuta Mustafayev, Gokhan Aydin, Gorkem Gungor, Bulend Yapici, Banu Atalar, Enis Ozyar
Brain metastases are commonly seen complications in non-small cell lung cancer (NSCLC) patients. The incidence of brain metastases is increasing as a result of more effective systemic targeted therapies with prolonged survival. The prognosis is usually poor, and up to six months of median survivals were reported with different therapeutic options. Here, we present an NSCLC case with multiple brain metastases treated with radiosurgery and systemic erlotinib therapy with prolonged survival. The use of tyrosine kinase inhibitors (TKI) in conjunction with either stereotactic radiosurgery or whole brain radiotherapy is not well established in terms of efficiency and toxicity...
December 29, 2017: Curēus
J P Agarwal, S Chakraborty, S G Laskar, N Mummudi, V M Patil, M Upasani, K Prabhash, V Noronha, A Joshi, N Purandare, S Tandon, J Arora, R Badhe
AIMS: The role of whole brain radiotherapy (WBRT) in patients with brain metastases from non-small cell lung cancers (NSCLC) has been questioned. However, no reliable criteria exist to identify patients who do not benefit from WBRT. The objective of the current study was to develop a prognostic model to identify such patients whose survival matches that of the Quality of Life after Treatment for Brain Metastases (QUARTZ) study. MATERIALS AND METHODS: Outcome data of patients with NSCLC with brain metastases undergoing WBRT enrolled in a prospective observational study in a tertiary cancer centre were used to develop a prognostic model...
February 27, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
Sabrina Rossi, Giovanna Finocchiaro, Silvia Marchetti, Luca Toschi, Armando Santoro
Despite efforts, brain metastases (BM) remain a critical issue in the management of patients affected by non-small-cell lung cancer (NSCLC). To date, radiotherapy is still considered the gold standard treatment; on the other hand, systemic chemotherapeutical agents are not so often an effective therapy for BM, whereas targeted agents in oncogene-addicted disease have shown a good activity also on BM. Anti-programmed death-1/programmed death ligand-1 agents represent a new valid therapeutic strategy for NSCLC as well as for several tumor types, but their efficacy on patients with BM is still unclear mainly due to the strict selection criteria adopted in clinical trials...
April 2018: Immunotherapy
Judith Murovic, Victoria Ding, Summer S Han, John R Adler, Steven D Chang
Introduction This study's objective is to assess various patient, tumor and imaging characteristics and to compare median overall survival (OS) of 150 patients with 1-12 brain metastases post-CyberKnife radiosurgery (CKRS) (Accuray, Sunnyvale, California) alone. Methods Charts of 150 patients, from 2009-2014, treated with only CKRS for brain metastases were reviewed retrospectively for patient, tumor, and imaging characteristics. Parameters included demographics, Eastern Cooperative Oncology Group (ECOG) performance scores, number and control of extracranial disease (ECD) sites, cause of death (COD), histology, tumor volume (TV), and post-CKRS whole brain radiotherapy (WBRT)...
December 8, 2017: Curēus
J Remon, N Vilariño, N Reguart
Immune checkpoint inhibitors (ICIs) have been incorporated in the treatment strategy of advanced non-small cell lung cancer (NSCLC). Beyond the already approved indications in first- and second-line setting of advanced NSCLC, new data has recently emerged demonstrating its efficacy in locally advanced disease as maintenance after chemo-radiotherapy and currently several trials are also exploring its efficacy in earlier stages of the disease to evaluate whether these results could be extrapolated to the adjuvant setting...
March 2018: Cancer Treatment Reviews
Ya-Wen Sun, Jian Xu, Jun Zhou, Wen-Juan Liu
Brain metastases are very common in lung cancer patients. The condition of these patients is complicated and difficult to treat, and adverse reactions following treatment can affect the nervous system, which severely reduces quality of life. Lung cancers are categorized as small cell lung cancers and non-small cell lung cancers. Patients with brain metastasis of small cell lung cancers are generally treated with brain radiotherapy and systemic chemotherapy, but stage III/IV patients with brain metastasis of non-small cell lung cancers are generally not responsive to radiotherapy or chemotherapy...
January 12, 2018: Oncotarget
Vishal Jindal, Sorab Gupta
Brain metastasis (BM) is one of the dreadful complications of malignancies. The prognosis after BM is extremely poor and life expectancy is meager. Currently, our treatment modalities are limited to radiotherapy and surgical resection, which also has poor outcomes and leads to various neurological deficits and affects the quality of life of patients. New treatment modality, i.e., immune checkpoint inhibitors, has brought revolution in management of melanoma, renal cancer, and non-small cell lung cancer (NSCLC)...
January 30, 2018: Molecular Neurobiology
J Garde-Noguera, P Martín Martorell, M De Julián, J Perez Altozano, C Salvador Coloma, J García Sánchez, A Insa Molla, M Martín, X Mielgo Rubio, S Marin Liébana, A Blasco Cordellat, S Blasco Molla, R Gironés, D Marquez Medina, F Aparisi, M C Bas Cerda, S Macia Escalante, A Sánchez, O Juan Vidal
BACKGROUND: Immunotherapy increases overall response rate (ORR) and overall survival (OS) in patients with non-small-cell lung cancer (NSCLC). Prognostic and predictive factors are a high need. PATIENTS AND METHODS: Retrospective review of NSCLC patients treated with nivolumab was performed. Analyzed variables included age, sex, stage, performance status (PS), location of metastases, presence of tumour-related symptoms and comorbidities, number of metastasis locations, previous chemotherapy, anti-angiogenic and radiotherapy treatments, and analytical data from the standard blood count and biochemistry...
January 24, 2018: Clinical & Translational Oncology
May N Tsao, Wei Xu, Rebecca Ks Wong, Nancy Lloyd, Normand Laperriere, Arjun Sahgal, Eileen Rakovitch, Edward Chow
BACKGROUND: This is an update to the review published in the Cochrane Library (2012, Issue 4).It is estimated that 20% to 40% of people with cancer will develop brain metastases during the course of their illness. The burden of brain metastases impacts quality and length of survival. OBJECTIVES: To assess the effectiveness and adverse effects of whole brain radiotherapy (WBRT) given alone or in combination with other therapies to adults with newly diagnosed multiple brain metastases...
January 25, 2018: Cochrane Database of Systematic Reviews
Petros Christopoulos, Volker Endris, Farastuk Bozorgmehr, Mei Elsayed, Martina Kirchner, Jonas Ristau, Ivo Buchhalter, Roland Penzel, Felix J Herth, Claus P Heussel, Martin Eichhorn, Thomas Muley, Michael Meister, Jürgen R Fischer, Stefan Rieken, Arne Warth, Helge Bischoff, Peter Schirmacher, Albrecht Stenzinger, Michael Thomas
In order to identify anaplastic lymphoma kinase-driven non-small cell lung cancer (ALK+ NSCLC) patients with a worse outcome, who might require alternative therapeutic approaches, we retrospectively analyzed all stage IV cases treated at our institutions with one of the main echinoderm microtubule-associated protein-like 4 (EML4)-ALK fusion variants V1, V2 and V3 as detected by next-generation sequencing or reverse transcription-polymerase chain reaction (n = 67). Progression under tyrosine kinase inhibitor (TKI) treatment was evaluated both according to Response Evaluation Criteria in Solid Tumors (RECIST) and by the need to change systemic therapy...
June 15, 2018: International Journal of Cancer. Journal International du Cancer
Ling-Ling Kong, Lin-Lin Wang, Li-Gang Xing, Jin-Ming Yu
Non-small cell lung cancer (NSCLC) continues to be one of the major causes of cancer-related deaths worldwide, and brain metastases are the major cause of death in NSCLC patients. With recent advances in understanding the underlying molecular mechanism of NSCLC development and progression, mutations in epidermal growth factor receptor ( EGFR ) have been recognized as a key predictor of therapeutic sensitivity to EGFR tyrosine kinase inhibitors (TKIs). Using EGFR-TKI alone or in combination with standard treatments such as whole-brain radiotherapy and surgery has been an effective strategy for the management of brain metastasis...
December 2017: Chronic diseases and translational medicine
Carsten Nieder, Thomas A Kämpe, Adam Pawinski, Astrid Dalhaug
BACKGROUND: Widely used prognostic scores, e. g., for brain or bone metastases, are based on disease- and patient-related factors such as extent of metastases, age and performance status, which were available in the databases used to develop the scores. Few groups were able to include patient-reported symptoms. In our department, all patients were assessed with the Edmonton Symptom Assessment System (ESAS, a one-sheet questionnaire addressing 11 major symptoms and wellbeing on a numeric scale of 0-10) at the time of treatment planning since 2012...
January 17, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Yongmei Liu, Lei Deng, Xiaojuan Zhou, Youling Gong, Yong Xu, Lin Zhou, Jin Wan, Bingwen Zou, Yongsheng Wang, Jiang Zhu, Zhenyu Ding, Feng Peng, Meijuan Huang, Li Ren, Tim Lautenschlaeger, Feng-Ming Spring Kong, You Lu
Epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) has intracranial activity in EGFR-mutant Non-Small Cell Lung Cancer (NSCLC). The optimal timing of brain radiotherapy (RT) and appropriate patients who need early brain RT remains undetermined. This is a retrospective study of EGFR-mutant NSCLC patients with newly diagnosed brain metastases (BMs) before EGFR-TKI initiation. Intra-cranial progression free survival (IC-PFS) and overall survival (OS) were measured from the date of EGFR-TKI treatment...
December 19, 2017: Oncotarget
Judith Murovic, Victoria Ding, Summer S Han, John R Adler, Steven D Chang
Introduction This study's objective is to compare the overall survivals (OSs) and various parameters of patients with 1-3 versus ≥ 4 brain metastases post-CyberKnife radiosurgery (CKRS) (Accuray, Sunnyvale, California) alone. Methods Charts of 150 patients, from 2009-2014, treated with only CKRS for brain metastases were reviewed retrospectively for overall survival (OS) and patient, tumor, and imaging characteristics. Parameters included demographics, Eastern Cooperative Oncology Group (ECOG) performance scores, number and control of extracranial disease (ECD) sites, cause of death (COD), histology, tumor volume (TV), and post-CKRS whole brain radiotherapy (WBRT)...
October 24, 2017: Curēus
Shinkichi Takamori, Gouji Toyokawa, Isamu Okamoto, Kazuki Takada, Fumihiko Kinoshita, Yuka Kozuma, Taichi Matsubara, Naoki Haratake, Takaki Akamine, Nobutaka Mukae, Fumihiko Hirai, Tetsuzo Tagawa, Yoshinao Oda, Toru Iwaki, Koji Iihara, Yoichi Nakanishi, Yoshihiko Maehara
AIM: To investigate the association between positivity for programmed cell death-ligand 1 (PD-L1) in brain metastases (BM) and the prognosis or clinical factors in patients with non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Thirty-two patients with surgically resected brain-metastatic NSCLC were enrolled. The PD-L1 expression in BM was analyzed using the antibody against human PD-L1 (clone SP142). The PD-L1 positivity was defined as PD-L1 expression on brain-metastatic tumor cells of ≥5%...
January 2018: Anticancer Research
Paul M Jeene, Kim C de Vries, Johanna G H van Nes, Johannes J M Kwakman, Gerda Wester, Tom Rozema, Pètra M Braam, Jaap D Zindler, Peter Koper, Joost J Nuyttens, Hanneke A Vos-Westerman, Ilona Schmeets, Charles G H J Niël, Stefan Hutschemaekers, Yvette M van der Linden, Joost J C Verhoeff, Lukas J A Stalpers
BACKGROUND: Whole brain radiotherapy (WBRT) is considered standard of care for patients with multiple brain metastases or unfit for radical treatment modalities. Recent studies raised discussion about the expected survival after WBRT. Therefore, we analysed survival after WBRT for brain metastases 'in daily practice' in a large nationwide multicentre retrospective cohort. METHODS: Between 2000 and 2014, 6325 patients had WBRT (20 Gy in 4 Gy fractions) for brain metastases from non-small cell lung cancer (NSCLC; 4363 patients) or breast cancer (BC; 1962 patients); patients were treated in 15 out of 21 Dutch radiotherapy centres...
December 23, 2017: Acta Oncologica
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