Prognostic Model for Intracranial Progression after Stereotactic Radiosurgery: A Multicenter Validation Study.

Journal Article (Journal Article)

Stereotactic radiosurgery (SRS) is a standard of care for many patients with brain metastases. To optimize post-SRS surveillance, this study aimed to validate a previously published nomogram predicting post-SRS intracranial progression (IP). We identified consecutive patients completing an initial course of SRS across two institutions between July 2017 and December 2020. Patients were classified as low- or high-risk for post-SRS IP per a previously published nomogram. Overall survival (OS) and freedom from IP (FFIP) were assessed via the Kaplan-Meier method. Assessment of parameters impacting FFIP was performed with univariable and multivariable Cox proportional hazard models. Among 890 patients, median follow-up was 9.8 months (95% CI 9.1-11.2 months). In total, 47% had NSCLC primary tumors, and 47% had oligometastatic disease (defined as ≤5 metastastic foci) at the time of SRS. Per the IP nomogram, 53% of patients were deemed high-risk. For low- and high-risk patients, median FFIP was 13.9 months (95% CI 11.1-17.1 months) and 7.6 months (95% CI 6.4-9.3 months), respectively, and FFIP was superior in low-risk patients (p < 0.0001). This large multisite BM cohort supports the use of an IP nomogram as a quick and simple means of stratifying patients into low- and high-risk groups for post-SRS IP.

Full Text

Duke Authors

Cited Authors

  • Carpenter, DJ; Natarajan, B; Arshad, M; Natesan, D; Schultz, O; Moravan, MJ; Read, C; Lafata, KJ; Giles, W; Fecci, P; Mullikin, TC; Reitman, ZJ; Kirkpatrick, JP; Floyd, SR; Chmura, SJ; Hong, JC; Salama, JK

Published Date

  • October 22, 2022

Published In

Volume / Issue

  • 14 / 21

PubMed ID

  • 36358606

Pubmed Central ID

  • PMC9657742

International Standard Serial Number (ISSN)

  • 2072-6694

Digital Object Identifier (DOI)

  • 10.3390/cancers14215186

Language

  • eng

Conference Location

  • Switzerland