Predicting intracranial progression following stereotactic radiosurgery for brain metastases: Implications for post SRS imaging


Journal Article

© 2019 Old City Publishing, Inc. 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.

Duke Authors

Cited Authors

  • Natarajan, BD; Rushing, CN; Cummings, MA; Jutzy, JMS; Choudhury, KR; Moravan, MJ; Fecci, PE; Adamson, J; Chmura, SJ; Milano, MT; Kirkpatrick, JP; Salama, JK

Published Date

  • January 1, 2019

Published In

Volume / Issue

  • 6 / 3

Start / End Page

  • 179 - 187

Electronic International Standard Serial Number (EISSN)

  • 2156-4647

International Standard Serial Number (ISSN)

  • 2156-4639

Citation Source

  • Scopus