Abstract

There is limited available literature examining factors that predispose patients to the development of LMC after stereotactic radiosurgery (SRS) for brain metastases. We sought to evaluate risk factors that may predispose patients to LMC after SRS treatment in this case–control study of patients with brain metastases who underwent single-fraction SRS between 2011 and 2016. Demographic and clinical information were collected retrospectively for 19 LMC cases and 30 controls out of 413 screened patients with brain metastases. Risk factors of interest were evaluated by univariate and multivariate logistic regression analyses and overall survival rates were evaluated by Kaplan–Meier survival analysis. About 5% of patients with brain metastases treated with SRS developed LMC. Patients with LMC (median 154 days, 95% CI 33–203 days) demonstrated a poorer overall survival than matched controls (median 417 days, 95% CI 121–512 days, p = 0.002). The most common primary tumor histologies that lead to the development of LMC were non-small cell lung cancer (36.8%), breast cancer (26.3%), and melanoma (21.1%). No association was found between the risk of LMC and the location of the brain lesion or total volume of brain metastases. Prior surgical resection of brain metastases before SRS was associated with a 6.5 times higher odds (95% CI 1.45–29.35, p = 0.01) of developing LMC post-radiosurgery compared to those with no prior resections of brain metastases. Additionally, adjuvant WBRT may help to reduce the risk of LMC and can be considered in decision-making for patients who have had brain metastasectomy.

Original languageEnglish (US)
Pages (from-to)395-401
Number of pages7
JournalJournal of neuro-oncology
Volume136
Issue number2
DOIs
StatePublished - Jan 1 2018

Fingerprint

Meningeal Carcinomatosis
Radiosurgery
Neoplasm Metastasis
Brain
Metastasectomy
Breast Neoplasms
Survival
Survival Analysis
Non-Small Cell Lung Carcinoma
Melanoma
Decision Making
Histology
Logistic Models
Regression Analysis
Demography

All Science Journal Classification (ASJC) codes

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

Keywords

  • Brain metasteses
  • Leptomeningeal carcinomatosis
  • Risk factor
  • Stereotactic radiosurgery

Cite this

@article{dcdf46393ab34f72aaffdd20788e181d,
title = "Risk of leptomeningeal carcinomatosis in patients with brain metastases treated with stereotactic radiosurgery",
abstract = "There is limited available literature examining factors that predispose patients to the development of LMC after stereotactic radiosurgery (SRS) for brain metastases. We sought to evaluate risk factors that may predispose patients to LMC after SRS treatment in this case–control study of patients with brain metastases who underwent single-fraction SRS between 2011 and 2016. Demographic and clinical information were collected retrospectively for 19 LMC cases and 30 controls out of 413 screened patients with brain metastases. Risk factors of interest were evaluated by univariate and multivariate logistic regression analyses and overall survival rates were evaluated by Kaplan–Meier survival analysis. About 5{\%} of patients with brain metastases treated with SRS developed LMC. Patients with LMC (median 154 days, 95{\%} CI 33–203 days) demonstrated a poorer overall survival than matched controls (median 417 days, 95{\%} CI 121–512 days, p = 0.002). The most common primary tumor histologies that lead to the development of LMC were non-small cell lung cancer (36.8{\%}), breast cancer (26.3{\%}), and melanoma (21.1{\%}). No association was found between the risk of LMC and the location of the brain lesion or total volume of brain metastases. Prior surgical resection of brain metastases before SRS was associated with a 6.5 times higher odds (95{\%} CI 1.45–29.35, p = 0.01) of developing LMC post-radiosurgery compared to those with no prior resections of brain metastases. Additionally, adjuvant WBRT may help to reduce the risk of LMC and can be considered in decision-making for patients who have had brain metastasectomy.",
keywords = "Brain metasteses, Leptomeningeal carcinomatosis, Risk factor, Stereotactic radiosurgery",
author = "Rosaline Ma and Morgan Levy and Bin Gui and Shou-En Lu and Venkat Narra and Sharad Goyal and Shabbar Danish and Simon Hanft and Atif Khan and Jyoti Malhotra and Sabin Motwani and Salma Jabbour",
year = "2018",
month = "1",
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doi = "10.1007/s11060-017-2666-7",
language = "English (US)",
volume = "136",
pages = "395--401",
journal = "Journal of Neuro-Oncology",
issn = "0167-594X",
publisher = "Kluwer Academic Publishers",
number = "2",

}

Risk of leptomeningeal carcinomatosis in patients with brain metastases treated with stereotactic radiosurgery. / Ma, Rosaline; Levy, Morgan; Gui, Bin; Lu, Shou-En; Narra, Venkat; Goyal, Sharad; Danish, Shabbar; Hanft, Simon; Khan, Atif; Malhotra, Jyoti; Motwani, Sabin; Jabbour, Salma.

In: Journal of neuro-oncology, Vol. 136, No. 2, 01.01.2018, p. 395-401.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk of leptomeningeal carcinomatosis in patients with brain metastases treated with stereotactic radiosurgery

AU - Ma, Rosaline

AU - Levy, Morgan

AU - Gui, Bin

AU - Lu, Shou-En

AU - Narra, Venkat

AU - Goyal, Sharad

AU - Danish, Shabbar

AU - Hanft, Simon

AU - Khan, Atif

AU - Malhotra, Jyoti

AU - Motwani, Sabin

AU - Jabbour, Salma

PY - 2018/1/1

Y1 - 2018/1/1

N2 - There is limited available literature examining factors that predispose patients to the development of LMC after stereotactic radiosurgery (SRS) for brain metastases. We sought to evaluate risk factors that may predispose patients to LMC after SRS treatment in this case–control study of patients with brain metastases who underwent single-fraction SRS between 2011 and 2016. Demographic and clinical information were collected retrospectively for 19 LMC cases and 30 controls out of 413 screened patients with brain metastases. Risk factors of interest were evaluated by univariate and multivariate logistic regression analyses and overall survival rates were evaluated by Kaplan–Meier survival analysis. About 5% of patients with brain metastases treated with SRS developed LMC. Patients with LMC (median 154 days, 95% CI 33–203 days) demonstrated a poorer overall survival than matched controls (median 417 days, 95% CI 121–512 days, p = 0.002). The most common primary tumor histologies that lead to the development of LMC were non-small cell lung cancer (36.8%), breast cancer (26.3%), and melanoma (21.1%). No association was found between the risk of LMC and the location of the brain lesion or total volume of brain metastases. Prior surgical resection of brain metastases before SRS was associated with a 6.5 times higher odds (95% CI 1.45–29.35, p = 0.01) of developing LMC post-radiosurgery compared to those with no prior resections of brain metastases. Additionally, adjuvant WBRT may help to reduce the risk of LMC and can be considered in decision-making for patients who have had brain metastasectomy.

AB - There is limited available literature examining factors that predispose patients to the development of LMC after stereotactic radiosurgery (SRS) for brain metastases. We sought to evaluate risk factors that may predispose patients to LMC after SRS treatment in this case–control study of patients with brain metastases who underwent single-fraction SRS between 2011 and 2016. Demographic and clinical information were collected retrospectively for 19 LMC cases and 30 controls out of 413 screened patients with brain metastases. Risk factors of interest were evaluated by univariate and multivariate logistic regression analyses and overall survival rates were evaluated by Kaplan–Meier survival analysis. About 5% of patients with brain metastases treated with SRS developed LMC. Patients with LMC (median 154 days, 95% CI 33–203 days) demonstrated a poorer overall survival than matched controls (median 417 days, 95% CI 121–512 days, p = 0.002). The most common primary tumor histologies that lead to the development of LMC were non-small cell lung cancer (36.8%), breast cancer (26.3%), and melanoma (21.1%). No association was found between the risk of LMC and the location of the brain lesion or total volume of brain metastases. Prior surgical resection of brain metastases before SRS was associated with a 6.5 times higher odds (95% CI 1.45–29.35, p = 0.01) of developing LMC post-radiosurgery compared to those with no prior resections of brain metastases. Additionally, adjuvant WBRT may help to reduce the risk of LMC and can be considered in decision-making for patients who have had brain metastasectomy.

KW - Brain metasteses

KW - Leptomeningeal carcinomatosis

KW - Risk factor

KW - Stereotactic radiosurgery

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