TY - JOUR
T1 - Predicting intracranial progression following stereotactic radiosurgery for brain metastases
T2 - Implications for post SRS imaging
AU - Natarajan, Brahma D.
AU - Rushing, Christel N.
AU - Cummings, Michael A.
AU - Jutzy, Jessica M.S.
AU - Choudhury, Kingshuk R.
AU - Moravan, Michael J.
AU - Fecci, Peter E.
AU - Adamson, Justus
AU - Chmura, Steven J.
AU - Milano, Michael T.
AU - Kirkpatrick, John P.
AU - Salama, Joseph K.
N1 - Publisher Copyright:
© 2019 Old City Publishing, Inc.
PY - 2019
Y1 - 2019
N2 - Purpose: Follow-up imaging after stereotactic radiosurgery (SRS) is crucial to identify salvageable brain metastases (BM) recurrence. As optimal imaging intervals are poorly understood, we sought to build a predictive model for time to intracranial progression. Methods: Consecutive patients treated with SRS for BM at three institutions from January 1, 2002 to June 30, 2017 were retrospectively reviewed. We developed a model using stepwise regression that identified four prognostic factors and built a predictive nomogram. Results: We identified 755 patients with primarily non-small cell lung, breast, and melanoma BMs. Factors such as number of BMs, histology, history of prior whole-brain radiation, and time interval from initial cancer diagnosis to metastases were prognostic for intracranial progression. Per our nomogram, risk of intracranial progression by 3 months post-SRS in the high-risk group was 21% compared to 11% in the low-risk group; at 6 months, it was 43% versus 27%. Conclusion: We present a nomogram estimating time to BM progression following SRS to potentially personalize surveillance imaging.
AB - Purpose: Follow-up imaging after stereotactic radiosurgery (SRS) is crucial to identify salvageable brain metastases (BM) recurrence. As optimal imaging intervals are poorly understood, we sought to build a predictive model for time to intracranial progression. Methods: Consecutive patients treated with SRS for BM at three institutions from January 1, 2002 to June 30, 2017 were retrospectively reviewed. We developed a model using stepwise regression that identified four prognostic factors and built a predictive nomogram. Results: We identified 755 patients with primarily non-small cell lung, breast, and melanoma BMs. Factors such as number of BMs, histology, history of prior whole-brain radiation, and time interval from initial cancer diagnosis to metastases were prognostic for intracranial progression. Per our nomogram, risk of intracranial progression by 3 months post-SRS in the high-risk group was 21% compared to 11% in the low-risk group; at 6 months, it was 43% versus 27%. Conclusion: We present a nomogram estimating time to BM progression following SRS to potentially personalize surveillance imaging.
KW - Brain metastases
KW - Nomogram
KW - Salvage therapy
KW - Surveillance imaging
UR - http://www.scopus.com/inward/record.url?scp=85071466613&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:85071466613
SN - 2156-4639
VL - 6
SP - 179
EP - 187
JO - Journal of Radiosurgery and SBRT
JF - Journal of Radiosurgery and SBRT
IS - 3
ER -