Purpose This study was to determine whether combining blood-brain-barrier-penetrant tyrosine kinase inhibitor (TKI), osimertinib, with intracranial radiotherapy (TKI + RT) would confer benefits exceeding those of osimertinib alone (TKI-alone) in terms of treatment outcomes among non-small cell lung cancer (NSCLC) patients with brain metastases and epidermal growth factor receptor (EGFR) mutation. Methods This single-center retrospective study focused on gamma-knife radiosurgery (GKRS) and whole brain radiotherapy (WBRT). Treatment outcomes included intracranial local tumor control, intracranial distant tumor control and overall survival (OS) rates. Results This study included 567 brain metastases in 69 patients: TKI-alone (n = 38) and TKI + RT (n = 31) including GKRS (n = 25) and WBRT (n = 6). Intracranial local tumor control at 36 months was significantly higher in the TKI + RT than in the TKI-alone (77% vs. 23%; p < 0.001). Intracranial distant tumor control was significantly higher in the TKI + RT than in the TKI-alone (median survival: 23.2 ± 1.5 vs. 8.7 ± 0.2 months; p < 0.001). We observed no difference between the two cohorts in terms of OS (p = 0.271). T790M point mutation (HR = 0.359, p = 0.008) and TKI + RT (HR = 0.396, p = 0.010) were positively correlated with intracranial local tumor control. The number of brain metastases was negatively correlated with intracranial distant tumor control (HR = 2.253, p = 0.034) and OS (HR = 2.049, p = 0.019). Conclusions The efficacy of osimertinib therapy for NSCLC patients with brain metastases and EGFR mutation was enhanced by combining this treatment with intracranial radiotherapy. Benefits were observed in terms of intracranial local control and distant control rates; however, no benefits were observed in terms of OS. Further prospective studies will be required to confirm these findings.
OBJECTIVE The goal of this study was to assess the safety and efficacy of single-session Gamma Knife radiosurgery (GKRS) for orbital cavernous hemangiomas (OCHs). METHODS Patients who presented with an OCH between September 1999 and May 2022 and were treated with single-session GKRS were included in this single-center cohort study. RESULTS There were 23 patients (7 males and 16 females) in this study. The median margin dose was 12 Gy (range 11–13 Gy). The median clinical and radiological follow-ups were 45 months (range 5–190 months) and 45 months (range 6–190 months), respectively. Nine (69.2%) of 13 patients with visual acuity impairment had improvement in best corrected visual acuity. Of the 8 patients with visual field defects, 5 patients (62.5%) had complete resolution. Tumor regression was observed in 22 patients (95.7%). The mean relative reduction in tumor volume was 82.6% ± 23.7%. The relative reductions in tumor volume were 33%, 49%, 72%, 84%, and 89% at 6, 12, 24, 36, and 48 months, respectively. Adverse effects of radiation were not observed. CONCLUSIONS GKRS appears to be safe and efficacious for treating OCHs over long-term follow-up. The treatment is associated with a high rate of regression in OCHs and remarkable improvement in both visual acuity and visual field deficits.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.