Comparative effectiveness of stereotactic radiosurgery versus whole-brain radiation therapy for patients with brain metastases from breast or non-small cell lung cancer.

التفاصيل البيبلوغرافية
العنوان:	Comparative effectiveness of stereotactic radiosurgery versus whole-brain radiation therapy for patients with brain metastases from breast or non-small cell lung cancer.
المؤلفون:	Halasz LM; Department of Radiation Oncology, University of Washington, Seattle, Washington., Uno H; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Hughes M; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., D'Amico T; Department of Surgery, Duke Cancer Institute, Durham, North Carolina., Dexter EU; Department of Surgery, Roswell Park Cancer Institute, Buffalo, New York.; University of Buffalo, Buffalo, New York., Edge SB; Department of Surgery, Roswell Park Cancer Institute, Buffalo, New York.; University of Buffalo, Buffalo, New York., Hayman JA; University of Michigan, Ann Arbor, Michigan., Niland JC; Information Sciences, City of Hope, Duarte, California., Otterson GA; Department of Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio., Pisters KM; Department of Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Theriault R; Department of Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Weeks JC; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Punglia RS; Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
المصدر:	Cancer [Cancer] 2016 Jul 01; Vol. 122 (13), pp. 2091-100. Date of Electronic Publication: 2016 Apr 18.
نوع المنشور:	Comparative Study; Journal Article; Multicenter Study
اللغة:	English
بيانات الدورية:	Publisher: Wiley Country of Publication: United States NLM ID: 0374236 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-0142 (Electronic) Linking ISSN: 0008543X NLM ISO Abbreviation: Cancer Subsets: MEDLINE
أسماء مطبوعة:	Publication: <2005- >: Hoboken, NJ : Wiley Original Publication: New York [etc.] Published for the American Cancer Society by J. Wiley [etc.]
مواضيع طبية MeSH:	Brain Neoplasms/radiotherapy , Brain Neoplasms/secondary , Breast Neoplasms/radiotherapy , Carcinoma, Non-Small-Cell Lung/radiotherapy , Cranial Irradiation/statistics & numerical data , Lung Neoplasms/radiotherapy , Radiosurgery/*statistics & numerical data, Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Propensity Score ; Survival Analysis ; Treatment Outcome
مستخلص:	Background: The optimal treatment for patients with brain metastases remains controversial as the use of stereotactic radiosurgery (SRS) alone, replacing whole-brain radiation therapy (WBRT), has increased. This study determined the patterns of care at multiple institutions before 2010 and examined whether or not survival was different between patients treated with SRS and patients treated with WBRT. Methods: This study examined the overall survival of patients treated with radiation therapy for brain metastases from non-small cell lung cancer (NSCLC; initially diagnosed in 2007-2009) or breast cancer (initially diagnosed in 1997-2009) at 5 centers. Propensity score analyses were performed to adjust for confounding factors such as the number of metastases, the extent of extracranial metastases, and the treatment center. Results: Overall, 27.8% of 400 NSCLC patients and 13.4% of 387 breast cancer patients underwent SRS alone for the treatment of brain metastases. Few patients with more than 3 brain metastases or lesions ≥ 4 cm in size underwent SRS. Patients with fewer than 4 brain metastases less than 4 cm in size (n = 189 for NSCLC and n = 117 for breast cancer) who were treated with SRS had longer survival (adjusted hazard ratio [HR] for NSCLC, 0.58; 95% confidence Interval [CI], 0.38-0.87; P = .01; adjusted HR for breast cancer, 0.54; 95% CI, 0.33-0.91; P = .02) than those treated with WBRT. Conclusions: Patients treated for fewer than 4 brain metastases from NSCLC or breast cancer with SRS alone had longer survival than those treated with WBRT in this multi-institutional, retrospective study, even after adjustments for the propensity to undergo SRS. Cancer 2016;122:2091-100. © 2016 American Cancer Society. (© 2016 American Cancer Society.)
التعليقات:	Comment in: Cancer. 2016 Oct 15;122(20):3244-3245. (PMID: 27391929) Comment in: Cancer. 2016 Oct 15;122(20):3243-3244. (PMID: 27392066)
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معلومات مُعتمدة:	K07 CA118269 United States CA NCI NIH HHS; RC2 CA148185 United States CA NCI NIH HHS
فهرسة مساهمة:	Keywords: breast neoplasms; comparative effectiveness research; neoplasm metastasis; non-small cell lung carcinoma; radiosurgery
تواريخ الأحداث:	Date Created: 20160419 Date Completed: 20170502 Latest Revision: 20181113
رمز التحديث:	20240628
مُعرف محوري في PubMed:	PMC4911286
DOI:	10.1002/cncr.30009
PMID:	27088755
قاعدة البيانات:	MEDLINE

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تدمد:	1097-0142
DOI:	10.1002/cncr.30009