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nsclc brain radiotherapy

Michael Huo, Peter Gorayski, Mark B Pinkham, Margot Lehman
BACKGROUND: Non-small cell lung cancer (NSCLC) is a leading cause of cancer-related death in Australia. Radiotherapy plays an important role in the curative and palliative settings. OBJECTIVE: This article reviews recent technological advances that have expanded the radiotherapy treatment options available, and presents standard and emerging approaches to NSCLC. DISCUSSION: General practitioners play an integral role in the care and education of patients during diagnosis, treatment and
follow-up of NSCLC...
November 2016: Australian Family Physician
Qiuyi Zhang, Xuchao Zhang, Honghong Yan, Benyuan Jiang, Chongrui Xu, Jinji Yang, Zhihong Chen, Jian Su, Yi-Long Wu, Qing Zhou
BACKGROUND: Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are remarkably effective for treating EGFR-mutant non-small cell lung cancer (NSCLC). However, the individual role of EGFR-TKIs in patients with brain metastasis (BM) arising from EGFR-mutant NSCLC remains unclear. METHODS: Patients with BM secondary to NSCLC and harboring EGFR-activating mutations were retrospectively screened. Patients who received gefitinib or erlotinib to control both extracranial lesions (ECLs) and intracranial lesions (ICLs) were eligible...
September 1, 2016: Thoracic Cancer
(no author information available yet)
Whole brain radiotherapy makes little or no difference to survival rates or quality of life in patients with non-small cell lung cancer (NSCLC) that has spread to the brain, say researchers.
September 28, 2016: Nursing Standard
Rafal Dziadziuszko
No abstract text is available yet for this article.
October 2016: Journal of Thoracic Oncology
Shojiro Minomo, Akihiro Tokoro, Tomoki Utsumi, Masahiro Ishihara, Masanori Akira, Shinji Atagi
Intramedullary spinal cord metastasis of non-small cell lung cancer is rare, and it has a short prognosis. We report a 53-year-old man diagnosed with cT4N0M0, stage IIIA squamous cell lung cancer. Ten months after left pneumonectomy (pT4N0M0), an intramedullary spinal cord tumor developed at the axis level. The intramedullary spinal cord tumor was resected, and he was diagnosed with metastatic squamous cell lung cancer. Radiotherapies and another tumor resection were conducted, as he had a good performance status and the discrete lesion was associated with the risk of brain stem compression...
August 2016: Journal of Thoracic Disease
Cécile Le Pechoux, Frederic Dhermain, Benjamin Besse
No abstract text is available yet for this article.
October 22, 2016: Lancet
Paula Mulvenna, Matthew Nankivell, Rachael Barton, Corinne Faivre-Finn, Paula Wilson, Elaine McColl, Barbara Moore, Iona Brisbane, David Ardron, Tanya Holt, Sally Morgan, Caroline Lee, Kathryn Waite, Neil Bayman, Cheryl Pugh, Benjamin Sydes, Richard Stephens, Mahesh K Parmar, Ruth E Langley
BACKGROUND: Whole brain radiotherapy (WBRT) and dexamethasone are widely used to treat brain metastases from non-small cell lung cancer (NSCLC), although there have been no randomised clinical trials showing that WBRT improves either quality of life or overall survival. Even after treatment with WBRT, the prognosis of this patient group is poor. We aimed to establish whether WBRT could be omitted without a significant effect on survival or quality of life. METHODS: The Quality of Life after Treatment for Brain Metastases (QUARTZ) study is a non-inferiority, phase 3 randomised trial done at 69 UK and three Australian centres...
October 22, 2016: Lancet
Yang Wang, Jian Fang, Jun Nie, Ling Dai, Weiheng Hu, Jie Zhang, Xiangjuan Ma, Jindi Han, Xiaoling Chen, Guangming Tian, Di Wu, Sen Han, Jieran Long
BACKGROUND: Radiotherapy combined with chemotherapy or molecular targeted therapy remains the standard of treatment for brain metastases from non-small cell lung cancer (NSCLC). The aim of this study is to determine if the deferral of brain radiotherapy impacts patient outcomes. METHODS: Between May 2003 and December 2015, a total of 198 patients with brain metastases from NSCLC who received both brain radiotherapy and systemic therapy (chemotherapy or targeted therapy) were identified...
August 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Guimei Liu, Xinyong Zhang, Cuimeng Tian, Guangrong Xia, Ping Liu, Quan Zhang, Xi Li, Hui Zhang, Na Qin, Jinghui Wang, Shucai Zhang
BACKGROUND: There is no high-level evidence for the time of whole brain radiotherapy (WBRT) for patients with epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) and brain metastases. The aim of this study is to assess the appropriate timing of WBRT for patients with EGFR-mutated NSCLC and brain metastases (BM). METHODS: There were 78 patients diagnosed with EGFR-mutated NSCLC and BM in Beijing Chest Hospital between August 2009 and May 2015...
August 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Yuzuru Niibe, Tetsuo Nishimura, Tetsuya Inoue, Katsuyuki Karasawa, Yoshiyuki Shioyama, Keiichi Jingu, Hiroki Shirato
BACKGROUND: To investigate the prognostic value of oligo-recurrence in patients with brain-only oligometastases of non-small cell lung cancer (NSCLC) treated with stereotactic radiosurgery (SRS) or stereotactic radiotherapy (SRT). METHODS: Patients treated with SRS or SRT for brain-only NSCLC oligometastases in 6 high-volume institutions in Japan between 1996 and 2008 were reviewed. Eligible patients met 1), 2), and 4) or 1), 3), and 4) of the following: 1) NSCLC with 1 to 4 brain metastases on magnetic resonance imaging (MRI) treated with SRS or SRT; 2) control of the primary lesions (thorax) at the time of SRS or SRT for brain metastases (patients meeting this criterion formed the oligo-recurrence group); 3) with SRS or SRT for brain metastases, concomitant treatment for active primary lesions (thorax) with curative surgery or curative stereotactic body radiotherapy (SBRT), or curative chemoradiotherapy (sync-oligometastases group); and 4) Karnofsky performance status (KPS) ≥70...
August 19, 2016: BMC Cancer
Yang-Si Li, Ben-Yuan Jiang, Jin-Ji Yang, Hai-Yan Tu, Qing Zhou, Wei-Bang Guo, Hong-Hong Yan, Yi-Long Wu
INTRODUCTION: Leptomeningeal metastases (LM) have increased in patients with NSCLC, and prognostic factors and outcomes for LM with EGFR gene mutations have not been well studied. METHODS: We retrospectively analyzed patients with lung cancer from January 2011 to June 2015 at our institute. Treatments and clinical outcomes of LM were reviewed. RESULTS: LM were diagnosed in 184 (3.4%) of 5387 patients with lung cancer. Patients with LM harboring EGFR mutations (9...
November 2016: Journal of Thoracic Oncology
Y N Sun, Z Y Zhang, Y C Zeng, F Chi, X Y Jin, R Wu
PURPOSE: We explored and compared the clinical effects of whole-brain radiotherapy (wbrt) with and without elemene liposomes in patients with multiple brain metastases from non-small-cell lung carcinoma (nsclc). METHODS: We retrospectively analyzed 62 patients with multiple brain metastases from nsclc who received wbrt (30 Gy in 10 fractions) at Shengjing Hospital of China Medical University from January 2012 to May 2013. In 30 patients, elemene liposomes (400 mg) were injected intravenously via a peripherally inserted central catheter for 21 consecutive days from the first day of radiotherapy...
August 2016: Current Oncology
Guangzhao He, Xiaoguang Xiao, Man Zou, Chengliang Zhang, Shu Xia
BACKGROUND: Brain metastases (BMs) are a common and serious complication of non-small cell lung cancer (NSCLC). Whole-brain radiotherapy (WBRT), surgery, and molecular targeted therapy are usually used to treat NSCLC with BM. Chemotherapeutic options for BM are limited by tumor resistance, ineffective agents, and the blood-brain barrier. Pemetrexed/cisplatin is the preferred chemotherapy in nonsquamous NSCLC, but the efficacy of this treatment for nonsquamous NSCLC with BM is uncertain...
August 2016: Medicine (Baltimore)
Hermann Reichegger, Wolfram Jochum, Diana Förbs, Claudia Hader, Martin Früh
BACKGROUND: Osimertinib (AZD9291, Tagrisso) is a potent, irreversible third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI). CASE REPORT: Our report demonstrates that osimertinib is able to inhibit the growth of a radiotherapy- and surgery-refractory EGFR T790M-positive brain metastasis in a patient with lung adenocarcinoma. CONCLUSION: These data show that re-biopsy in EGFR-mutated non-small cell lung cancer patients with acquired TKI resistance should be performed...
2016: Oncology Research and Treatment
Seonggyu Byeon, Jun Soo Ham, Jong-Mu Sun, Se-Hoon Lee, Jin Seok Ahn, Keunchil Park, Myung-Ju Ahn
Although cranial radiotherapy is considered the standard treatment for brain metastasis (BM), EGFR tyrosine kinase inhibitors (TKIs) have shown promising activity in EGFR mutant non-small cell lung cancer (NSCLC) patients with BM. However, the efficacy of sequential cranial radiotherapy in patients with EGFR mutant NSCLC who are treated with EGFR TKIs remains to be determined. Patients with NSCLC who harbored an EGFR mutation and whose BM had been treated with EGFR TKIs were retrospectively reviewed. The clinical outcomes of patients treated with EGFR TKIs alone and those treated with cranial radiotherapy followed by EGFR TKIs (additive therapy) were compared...
August 2016: Medical Oncology
Ya-Lan Wu, Lin Zhou, You Lu
Leptomeningeal metastasis (LM) is increasingly common in patients with non-small cell lung cancer (NSCLC) due to improved treatment, and ultimately, prolonged patient survival. The current study is a pooled analysis that evaluated intrathecal chemotherapy (ITC) as a treatment for NSCLC patients with LM. The PUBMED, OVID, EBSCO and Cochrane Library databases were searched for published studies involving ITC in NSCLC patients with LM. The primary outcomes of interest included response (symptomatic, radiographic and cytological) and survival...
August 2016: Oncology Letters
Maximilian Hochmair, Sophia Holzer, Otto C Burghuber
In patients with non-small-cell lung cancer, the presence of brain metastases requires specific treatment due to the unfavourable overall impact of these lesions. Treatment with the tyrosine kinase inhibitor afatinib was shown to induce complete and long-lasting remissions in the five patients described here. All of them had multiple brain lesions and presented with symptoms. Study evidence suggests beneficial effects of afatinib in this respect, underlining these clinical observations. Afatinib might be incorporated into current treatment algorithms, allowing for the omission of radiotherapy, provided that larger phase III trials confirm the potential of epidermal growth factor receptor tyrosine kinase inhibitors in this respect...
October 2016: Anti-cancer Drugs
Liang-Hua Ma, Guang Li, Hong-Wei Zhang, Zhi-Yu Wang, Jun Dang, Shuo Zhang, Lei Yao
BACKGROUND: The purpose of this study was to investigate the impact of histology on survival stratified by the Graded Prognostic Assessment (GPA) for non-small cell lung cancer (NSCLC) in a group of selected patients treated recently. METHODS: A total of 171 NSCLC patients with brain metastases treated by hypofractionated stereotactic radiotherapy with or without whole-brain radiotherapy between 2001 and 2011 were included. The GPA score was calculated for each patient...
July 13, 2016: Radiation Oncology
Charlotte Billiet, Dirk De Ruysscher, Stéphanie Peeters, Herbert Decaluwé, Johan Vansteenkiste, Christophe Dooms, Christophe M Deroose, Paul De Leyn, Marc Hendrikx, Paul Bulens, Cécile Le Péchoux, Jeroen Mebis
OBJECTIVES: Our aim was to evaluate locoregional relapse (LR) patterns after induction chemotherapy and surgery for stage III-N2 NSCLC staged with current standard methods and their impact on radiation target volumes for postoperative radiotherapy (PORT). METHODS: A total of 150 patients with stage III-N2 NSCLC from a prospective database of patients who underwent surgical resection at the University Hospitals of Leuven or the Oncologic Centre Limburg between 1998 and 2012 were included...
September 2016: Journal of Thoracic Oncology
Jonathan Khalifa, Arya Amini, Sanjay Popat, Laurie E Gaspar, Corinne Faivre-Finn
Brain metastases (BMs) will develop in a large proportion of patients with NSCLC throughout the course of their disease. Among patients with NSCLC with oncogenic drivers, mainly EGFR activating mutations and anaplastic lymphoma receptor tyrosine kinase gene (ALK) rearrangements, the presence of BM is a common secondary localization of disease both at the time of diagnosis and at relapse. Because of the limited penetration of a wide range of drugs across the blood-brain barrier, radiotherapy is considered the cornerstone of treatment of BMs...
October 2016: Journal of Thoracic Oncology
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