Brain metastases in locally advanced nonsmall cell lung carcinoma after multimodality treatment

Cancer ◽  
2002 ◽  
Vol 95 (3) ◽  
pp. 605-612 ◽  
Author(s):  
Giovanni Luca Ceresoli ◽  
Michele Reni ◽  
Giuseppe Chiesa ◽  
Angelo Carretta ◽  
Stefano Schipani ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Lung Carcinoma ◽  
Locally Advanced ◽  
Multimodality Treatment ◽  
Cell Lung Carcinoma ◽  
Nonsmall Cell Lung Carcinoma

scholarly journals Alternating chemotherapy and accelerated split-course irradiation in locally advanced nonsmall cell lung carcinoma

Cancer ◽  
1999 ◽  
Vol 85 (10) ◽  
pp. 2144-2150 ◽  
Author(s):  
Thierry Pignon ◽  
Sophie Ruggieri ◽  
Christian Boutin ◽  
Joanny Gouvernet ◽  
Michel Irisson ◽  
...  
Keyword(s):  
Lung Carcinoma ◽  
Locally Advanced ◽  
Cell Lung Carcinoma ◽  
Nonsmall Cell Lung Carcinoma ◽  
Alternating Chemotherapy

scholarly journals The possible advantage of hyperfractionated thoracic radiotherapy in the treatment of locally advanced nonsmall cell lung carcinoma

Cancer ◽  
1998 ◽  
Vol 82 (6) ◽  
pp. 1037-1048 ◽  
Author(s):  
James A. Bonner ◽  
William L. McGinnis ◽  
Phillip J. Stella ◽  
Robert F. Marschke ◽  
Jeff A. Sloan ◽  
...  
Keyword(s):  
Lung Carcinoma ◽  
Locally Advanced ◽  
Thoracic Radiotherapy ◽  
Cell Lung Carcinoma ◽  
Nonsmall Cell Lung Carcinoma

Factors Affecting the Risk of Brain Metastases After Definitive Chemoradiation for Locally Advanced Non–Small-Cell Lung Carcinoma

2001 ◽  
Vol 19 (5) ◽  
pp. 1344-1349 ◽  
Author(s):  
Theodore J. Robnett ◽  
Mitchell Machtay ◽  
James P. Stevenson ◽  
Kenneth M. Algazy ◽  
Stephen M. Hahn
Keyword(s):  
Brain Metastases ◽  
Brain Imaging ◽  
Lung Carcinoma ◽  
Small Cell Lung Carcinoma ◽  
Performance Status ◽  
Locally Advanced ◽  
Small Cell ◽  
Stage Ii ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma

PURPOSE: As therapy for locally advanced non–small-cell lung carcinoma (NSCLC) improves, brain metastases (BM) may become a greater problem. We analyzed our chemoradiation experience for patients at highest risk for the brain as the first failure site. METHODS: Records for 150 consecutive patients with stage II/III NSCLC treated definitively with chemoradiation from June 1992 to June 1998 at the University of Pennsylvania were reviewed. Most patients (89%) received cisplatin, paclitaxel, or both. All had negative brain imaging before treatment. Posttreatment brain imaging was performed for suspicious symptoms. Incidence of BM was examined as a function of age, sex, histology, stage, performance status, weight loss, tumor location, surgery, radiation dose, initial radiation field, chemotherapy regimen, and chemotherapy timing. RESULTS: Crude and 2-year actuarial rates of BM were 19% and 30%, respectively. Among pretreatment parameters, stage IIIB was associated with a higher risk of BM (P < .04) versus stage II/IIIA. Histology alone was not significant (P < .12), although patients with IIIB nonsquamous tumors had an exceptionally high 2-year BM rate of 42% (P < .01 v all others). Examining treatment-related parameters, crude and 2-year actuarial risk of BM were 27% and 39%, respectively, in patients receiving chemotherapy before radiotherapy and 15% and 20%, respectively, when radiotherapy was not delayed (P < .05). On multivariate analysis, timing of chemotherapy (P < .01) and stage IIIA versus IIIB (P < .01) remained significant. CONCLUSION: Patients with later stage, nonsquamous NSCLC, particularly those receiving induction chemotherapy, have sufficiently common BM rates to justify future trials including prophylactic cranial irradiation.

scholarly journals Immunohistochemical markers associated with brain metastases in patients with nonsmall cell lung carcinoma

Cancer ◽  
2008 ◽  
Vol 113 (8) ◽  
pp. 2129-2138 ◽  
Author(s):  
Ali G. Saad ◽  
Beow Y. Yeap ◽  
Frederik B. J. M. Thunnissen ◽  
Geraldine S. Pinkus ◽  
Jack L. Pinkus ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Lung Carcinoma ◽  
Cell Lung Carcinoma ◽  
Immunohistochemical Markers ◽  
Nonsmall Cell Lung Carcinoma

scholarly journals Nonsmall Cell Lung Carcinoma with Giant Cell Features Expressing Programmed Death-Ligand 1: A Report of a Patient Successfully Treated with Pembrolizumab

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Shingo Nakayama ◽  
Mamoru Sasaki ◽  
Shojiroh Morinaga ◽  
Naoto Minematsu
Keyword(s):  
Brain Metastases ◽  
Cell Carcinoma ◽  
Giant Cell ◽  
Tumor Cells ◽  
Lung Carcinoma ◽  
Cell Lung Carcinoma ◽  
Programmed Death Ligand 1 ◽  
Giant Cell Carcinoma ◽  
Nonsmall Cell Lung Carcinoma ◽  
Programmed Death

Giant cell carcinoma, a rare variant of nonsmall cell lung carcinoma (NSCLC), is characterized by aggressive progression and poor response to conventional chemotherapy. This report is the first to describe a patient with NSCLC and giant cell features who was successfully treated with pembrolizumab, an antibody targeting programmed death-1 (PD-1). A 69-year-old woman was diagnosed with NSCLC with multiple brain metastases. Histological evaluation of lung biopsy specimens revealed proliferation of pleomorphic giant tumor cells with poor cohesiveness, findings consistent with giant cell carcinoma. Immunostaining showed that a high proportion of the tumor cells were positive for expression of programmed death-ligand 1 (PD-L1). The patient received stereotactic radiotherapy for the brain metastases, followed by administration of pembrolizumab. Treatment with pembrolizumab resulted in the rapid regression of the primary lung nodule, with the progression-free period maintained for at least four treatment cycles. Immunotherapy targeting PD-1/PD-L1 may be an option for patients with PD-L1-positive NSCLC with giant cell features.

Radiosurgery for patients with recurrent small cell lung carcinoma metastatic to the brain: outcomes and prognostic factors

2005 ◽  
Vol 102 (Special_Supplement) ◽  
pp. 247-254 ◽  
Author(s):  
Jason Sheehan ◽  
Douglas Kondziolka ◽  
John Flickinger ◽  
L. Dade Lunsford
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Lung Carcinoma ◽  
Small Cell Lung Carcinoma ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Content Type ◽  
The Brain ◽  
Fine Print

Object. Lung carcinoma is the leading cause of death from cancer. More than 50% of those with small cell lung cancer develop a brain metastasis. Corticosteroid agents, radiotherapy, and resection have been the mainstays of treatment. Nonetheless, median survival for patients with small cell lung carcinoma metastasis is approximately 4 to 5 months after cranial irradiation. In this study the authors examine the efficacy of gamma knife surgery for treating recurrent small cell lung carcinoma metastases to the brain following tumor growth in patients who have previously undergone radiation therapy, and they evaluate factors affecting survival. Methods. A retrospective review of 27 patients (47 recurrent small cell lung cancer brain metastases) undergoing radiosurgery was performed. Clinical and radiographic data obtained during a 14-year treatment period were collected. Multivariate analysis was utilized to determine significant prognostic factors influencing survival. The overall median survival was 18 months after the diagnosis of brain metastases. In multivariate analysis, factors significantly affecting survival included: 1) tumor volume (p = 0.0042); 2) preoperative Karnofsky Performance Scale score (p = 0.0035); and 3) time between initial lung cancer diagnosis and development of brain metastasis (p = 0.0127). Postradiosurgical imaging of the brain metastases revealed that 62% decreased, 19% remained stable, and 19% eventually increased in size. One patient later underwent a craniotomy and tumor resection for a tumor refractory to radiosurgery and radiation therapy. In three patients new brain metastases were demonstrating on follow-up imaging. Conclusions. Stereotactic radiosurgery for recurrent small cell lung carcinoma metastases provided effective local tumor control in the majority of patients. Early detection of brain metastases, aggressive treatment of systemic disease, and a therapeutic strategy including radiosurgery can extend survival.

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