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Pulmonary resection in patients with nonsmall-cell lung cancer treated with gamma-knife radiosurgery for synchronous brain metastases

Cited 12 time in Web of Science Cited 21 time in Scopus
Authors
Yang, Seung-Yeob; Kim, Dong Gyu; Lee, Se-Hoon; Chung, Hyun-Tai; Paek, Sun Ha; Kim, Joo Hyun; Jung, Hee-Won; Han, Dae Hee
Issue Date
2008-02-27
Publisher
Wiley-Blackwell
Citation
Cancer. 2008;112(8):1780-1786
Keywords
AdultAgedAntineoplastic Agents/therapeutic useAntineoplastic Agents, Phytogenic/administration & dosageAntineoplastic Combined Chemotherapy Protocols/therapeutic useBrain Neoplasms/*secondary/surgeryCarcinoma, Non-Small-Cell Lung/secondary/*surgeryCase-Control StudiesChemotherapy, AdjuvantCisplatin/administration & dosageCohort StudiesFemaleFollow-Up StudiesHumansLung Neoplasms/*surgeryMaleMiddle AgedNeoplasm StagingPaclitaxel/administration & dosagePneumonectomy/*methodsRadiosurgery/*methodsRetrospective StudiesSurvival Rate
Abstract
BACKGROUND: The aim of the current study was to determine whether a pulmonary resection and gamma-knife radiosurgery (GKRS) protocol is superior to GKRS alone in selected patients with stage IV nonsmall-cell lung cancer (NSCLC). METHODS: The authors performed a retrospective case-control study of 232 consecutive patients with newly diagnosed NSCLC from January 1998 to December 2005 and screened them to identify a study cohort in which all patients had thoracic stage I or II, Karnofsky performance status >or= 70, no extracranial metastases, and 1-3 synchronous brain metastases of less than 3 cm, and were treated with GKRS (n=31). The study cohort was divided into 2 groups, those with and without concomitant pulmonary resection. RESULTS: Sixteen patients with pulmonary resection were assigned to the treatment group and 15 without pulmonary resection were assigned to the control group. Median follow-up was 27.3 months (range, 4.4 months to 90.9 months). Mean survivals for the treatment group and the control group were 64.9 and 18.1 months, respectively (P< .001). There was a statistically significant association between pulmonary resection and better survival (OR=78.408). One-year and 5-year local brain tumor control rates were 97.1% and 93.5%, respectively. CONCLUSIONS: The pulmonary resection and GKRS protocol could prolong survival in patients with thoracic stage I or II NSCLC, no extracranial metastases, and a limited number of small synchronous brain metastases.
ISSN
0008-543X (Print)
Language
English
URI
https://hdl.handle.net/10371/68201
DOI
https://doi.org/10.1002/cncr.23357
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College of Medicine/School of Medicine (의과대학/대학원)Neurosurgery (신경외과학전공)Journal Papers (저널논문_신경외과학전공)
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