Gamma knife surgery for non-small cell lung cancer patients with brain metastasis: A community cancer center experience.

Abstract

e18054 Background: For patients with non-small cell lung cancer (NSCLC) and brain metastasis, the options available for treatment depend on several different factors. For those with brain metastasis who are qualifying candidates, gamma knife surgery (GKS) is an alternative to invasive neurosurgery. At Archbold Lewis Hall Singletary Oncology Center in Thomasville, Georgia, GKS can be provided as an option for treating NSCLC with brain metastasis. Our study performed in a small, community setting has shown results comparable to those found in patients treated in larger university settings. Methods: A retrospective review of 92 patients who had undergone GKS to treat a total of 276 NSCLC metastases was performed. Clinical data encompassing a 7-year treatment interval were collected. The histology of primary NSCLC was classified as adenocarcinoma (n=50), squamous (n=19), or undefined (n=23). Fifty-two patients had no active extra cranial disease at time of treatment with GKS and 24 patients received whole brain radiation therapy (WBRT) prior to GKS. A number of patients received concomitant regimen to primary site with radiation alone (n=10), chemo alone (n=9), radiation and chemo (n=30), surgery (n=31), none (n=9) and unknown (n=3). There were 48 men and 44 women, which were 75% Caucasian, 24% African American, and 1% Hispanic. The average patient age was 64.8. The average Karnofsky Perfomance Scale was 70.3. Results: The overall mean patient survival time was 9.9 months, ranging from 10 days to 78.7 months, from the date of first treatment of GKS. The mean survival time was 8.9 months for those diagnosed with adenocarcinoma, 10.8 months for those diagnosed with squamous cell carcinoma, and 11.6 months for those with undefined pathology. Mean survival time of patients without active extra cranial disease was 10.5 months. The patients that received WBRT prior to GKS averaged a survival of 16.7 months. African American patients had an average survival time of 7.8 months compared to 10.7 months for Caucasian patients. Conclusions: Gamma knife surgery for NSCLC with brain metastasis can serve as a treatment option in a community setting and produce results comparable to those seen in large university settings.