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Perilesional edema in brain metastasis from non-small cell lung cancer (NSCLC) as predictor of response to radiosurgery (SRS)

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Abstract

Radiosurgery (SRS) is widely used in the treatment of brain oligo-metastases from NSCLC. The aim of present study is to evaluate the extent of perilesional edema in brain metastases as predictive factor of treatment response. This single center retrospective study included 42 consecutive patients (January 2011–December 2014) with 1–2 brain metastasis from NSCLC treated with Radiosurgery (SRS). Extent of perilesional edema was measured as maximal extension from the edge of lesion and classified as minor (<10 mm) or major (≥10 mm). We analyzed Modality of Brain Recurrence (MBR), classified as in-field or out-of- field, and Brain Progression Free-Survival (BPFS) after treatment stratified according to extent of perilesional edema. Analyzing modality of brain recurrence and BPFS, after a median follow-up of 6 months, we found that patients with minor edema had a better radiological response to SRS with none in-field recurrences and a lower risk of the onset of new brain lesions (out-of-field recurrence). Instead, patients group with major edema had a worse response rate of lesions treated, further, a higher risk of out-of-field brain relapse. Extent of perilesional edema in brain metastasis from NSCLC could be a predictive factor of response and brain progression after SRS treatment alone.

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Authors and Affiliations

  1. IstitutoToscanoTumori, Florence, Italy

    Paolo Tini, Valerio Nardone, Pierpaolo Pastina, Giuseppe Battaglia, Tommaso Carfagno, Giovanni Rubino, Salvatore Francesco Carbone, Lucio Sebaste & Luigi Pirtoli

  2. Unit of Radiation Oncology, University Hospital of Siena, Policlinico S. Maria Alle Scotte, Viale Bracci, 53100, Siena, Italy

    Paolo Tini, Tommaso Carfagno, Giovanni Rubino, Lucio Sebaste & Luigi Pirtoli

  3. Department of Medicine, Surgery and Neurological Sciences, Research Center for Molecular Radiobiology, University of Siena, Siena, Italy

    Paolo Tini, Valerio Nardone, Pierpaolo Pastina, Giuseppe Battaglia & Luigi Pirtoli

  4. Unit of Clinical Neurology and Neurometabolic Disorders, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy

    Claudia Vinciguerra & Antonio Federico

  5. Unit of Diagnostic Radiology, University Hospital of Siena, Siena, Italy

    Salvatore Francesco Carbone

  6. Unit of Neuroradiology, University Hospital of Siena, Siena, Italy

    Alfonso Cerase

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  1. Paolo Tini
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Correspondence to Paolo Tini.

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Tini, P., Nardone, V., Pastina, P. et al. Perilesional edema in brain metastasis from non-small cell lung cancer (NSCLC) as predictor of response to radiosurgery (SRS). Neurol Sci 38, 975–982 (2017). https://doi.org/10.1007/s10072-017-2876-y

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