2023
Use of stereotactic radiosurgery in treatment of brain metastases from pediatric extracranial solid tumors
Xu S, Campbell A, Chiang V, Bindra R, Vasquez J, Pashankar F. Use of stereotactic radiosurgery in treatment of brain metastases from pediatric extracranial solid tumors. Pediatric Blood & Cancer 2023, 70: e30303. PMID: 36975152, DOI: 10.1002/pbc.30303.Peer-Reviewed Original ResearchLocal Control and Survival Outcomes After Stereotactic Radiosurgery for Brain Metastases From Gastrointestinal Primaries: An International Multicenter Analysis
Singh R, Bowden G, Mathieu D, Perlow H, Palmer J, Elhamdani S, Shepard M, Liang Y, Nabeel A, Reda W, Tawadros S, Abdelkarim K, El-Shehaby A, Emad R, Elazzazi A, Warnick R, Gozal Y, Daly M, McShane B, Addis-Jackson M, Karthikeyan G, Smith S, Picozzi P, Franzini A, Kaisman-Elbaz T, Yang H, Wei Z, Legarreta A, Hess J, Templeton K, Pikis S, Mantziaris G, Simonova G, Liscak R, Peker S, Samanci Y, Chiang V, Niranjan A, Kersh C, Lee C, Trifiletti D, Lunsford L, Sheehan J. Local Control and Survival Outcomes After Stereotactic Radiosurgery for Brain Metastases From Gastrointestinal Primaries: An International Multicenter Analysis. Neurosurgery 2023, 93: 592-598. PMID: 36942965, DOI: 10.1227/neu.0000000000002456.Peer-Reviewed Original ResearchConceptsKarnofsky performance statusStereotactic radiosurgeryOverall survivalBrain metastasesUnivariate analysisLocal controlGI primaryExtracranial metastasesPrognostic factorsBrain metastases treated with stereotactic radiosurgeryAssociated with inferior LCAssociated with inferior OSMedian Karnofsky performance statusEvaluate potential prognostic factorsInternational multicenter analysisPlanning target volumePotential prognostic factorsKaplan-Meier analysisOne-yearProportional hazards modelInferior LCInferior OSOS ratesLC ratesGastrointestinal primaryPreliminary dosimetric comparison between fixed and rotating source stereotactic radiosurgery systems
Draeger E, Chen Z, Hansen J, Chiang V, Tien C. Preliminary dosimetric comparison between fixed and rotating source stereotactic radiosurgery systems. Journal Of Applied Clinical Medical Physics 2023, 24: e13907. PMID: 36660774, PMCID: PMC10161057, DOI: 10.1002/acm2.13907.Peer-Reviewed Original ResearchConceptsConformity indexRadiation Therapy Oncology Group conformity indexGK plansSuperior conformity indexNon-metastatic casesPaddick conformity indexDosimetric plan qualityGK patientsBrain metastasesRadiosurgery systemTrigeminal neuralgiaPrescription dosesGamma Knife systemMetastatic casesArteriovenous malformationsPituitary adenomasConformality indexLarge cohortDosimetric comparisonStereotactic radiosurgery systemGK IconPatientsCohortTreatment timeDosimetric resultsTransfrontal Approach to the Amygdala for Ablation With Laser Interstitial Thermal Therapy: An Epilepsy Case Report
Lamsam L, Brigido M, Sivaraju A, Hirsch L, Spencer D, Chiang V, Damisah E. Transfrontal Approach to the Amygdala for Ablation With Laser Interstitial Thermal Therapy: An Epilepsy Case Report. Operative Neurosurgery 2023, 24: e381-e384. PMID: 36715982, PMCID: PMC10158899, DOI: 10.1227/ons.0000000000000576.Peer-Reviewed Original ResearchConceptsStereotactic laser amygdalohippocampotomyLaser interstitial thermal therapyEntorhinal cortexInterstitial thermal therapyComplete ablationMesial temporal lobe epilepsyTemporal arteriovenous malformationTemporal lobe epilepsyLeft temporal arteriovenous malformationMiddle frontal gyrusPrior craniotomyOpen resectionLobe epilepsyCase reportMedial amygdalaArteriovenous malformationsAnterior entorhinal cortexTransfrontal approachAmygdalaInvasive surgeryFrontal gyrusThermal therapyIntracranial electroencephalographyResection
2022
Brain metastatic outgrowth and osimertinib resistance are potentiated by RhoA in EGFR-mutant lung cancer
Adua S, Arnal-Estapé A, Zhao M, Qi B, Liu Z, Kravitz C, Hulme H, Strittmatter N, López-Giráldez F, Chande S, Albert A, Melnick M, Hu B, Politi K, Chiang V, Colclough N, Goodwin R, Cross D, Smith P, Nguyen D. Brain metastatic outgrowth and osimertinib resistance are potentiated by RhoA in EGFR-mutant lung cancer. Nature Communications 2022, 13: 7690. PMID: 36509758, PMCID: PMC9744876, DOI: 10.1038/s41467-022-34889-z.Peer-Reviewed Original ResearchConceptsGene expression programsRas homolog family member ACancer cellsFamily member AEpidermal growth factor receptorExpression programsMetastatic cancer cellsSRF signalingGrowth factor receptorTumor microenvironmentLung cancerFunctional linkExtracellular lamininDrug-resistant cancer cellsMutant non-small cell lung cancerNon-small cell lung cancerCentral nervous system relapseMolecular studiesMember AEGFR-mutant lung cancerFactor receptorNervous system relapseCell lung cancerDisseminated tumor cellsBrain tumor microenvironmentMulticenter analysis of stereotactic radiosurgery for multiple brain metastases from EGFR and ALK driven non-small cell lung cancer
Wandrey N, Gao D, Robin T, Contessa J, Singh C, Chiang V, Li J, Chen A, Wang Y, Sheehan J, Dutta S, Weiss S, Paly J, Rusthoven C. Multicenter analysis of stereotactic radiosurgery for multiple brain metastases from EGFR and ALK driven non-small cell lung cancer. Lung Cancer 2022, 176: 144-148. PMID: 36641932, PMCID: PMC10552603, DOI: 10.1016/j.lungcan.2022.11.019.Peer-Reviewed Original ResearchConceptsNon-small cell lung cancerOverall survivalCell lung cancerStereotactic radiosurgeryBrain metastasesMultivariable adjustmentMulticenter analysisLung cancerNext-generation tyrosine kinase inhibitorsSRS treatmentOnly negative prognostic factorWhole brain radiotherapyMedian overall survivalMultiple brain metastasesNegative prognostic factorFavorable overall survivalTyrosine kinase inhibitorsTreatment 1CNS progressionMulticenter outcomesMedian followPrognostic factorsFavorable prognosisCNS diseaseTreatment optionsBrain metastases: A Society for Neuro-Oncology (SNO) consensus review on current management and future directions
Aizer AA, Lamba N, Ahluwalia MS, Aldape K, Boire A, Brastianos PK, Brown PD, Camidge DR, Chiang VL, Davies MA, Hu LS, Huang RY, Kaufmann T, Kumthekar P, Lam K, Lee EQ, Lin NU, Mehta M, Parsons M, Reardon DA, Sheehan J, Soffietti R, Tawbi H, Weller M, Wen PY. Brain metastases: A Society for Neuro-Oncology (SNO) consensus review on current management and future directions. Neuro-Oncology 2022, 24: 1613-1646. PMID: 35762249, PMCID: PMC9527527, DOI: 10.1093/neuonc/noac118.Peer-Reviewed Original ResearchConceptsBrain metastasesConsensus reviewAdvanced solid malignanciesManagement of patientsOncologic careSimilar incidenceConsensus guidelinesSolid malignanciesDedicated trialsNeuro-oncologyMetastasisCurrent managementPatientsCareFurther explorationMalignancyReviewGroup discussionsManagementIncidenceTrialsExecutive summary of American Radium Society’s appropriate use criteria for the postoperative management of lower grade gliomas
Tom MC, Milano MT, Chao ST, Soltys SG, Knisely JPS, Sahgal A, Nagpal S, Lo SS, Jabbari S, Wang TJC, Ahluwalia MS, Simonson M, Palmer JD, Gephart MH, Halasz LM, Garg AK, Chiang VLS, Chang EL. Executive summary of American Radium Society’s appropriate use criteria for the postoperative management of lower grade gliomas. Radiotherapy And Oncology 2022, 170: 79-88. PMID: 35367527, DOI: 10.1016/j.radonc.2022.03.018.Peer-Reviewed Original ResearchConceptsLow-grade gliomasAppropriate use criteriaGrade 2 gliomasGrade 3 gliomasPostoperative managementGrade gliomasIDH-mutant oligodendrogliomasPostoperative therapyRadiotherapy doseAmerican Radium Society Appropriate Use CriteriaGrade 2Gross total surgical resectionImmediate adjuvant therapyHigh-risk featuresType of chemotherapyLow-risk featuresAppropriate treatment optionsIDH-mutant astrocytomasAdjuvant therapyModality therapySurgical resectionConsensus guidelinesTreatment optionsClose surveillanceConsensus recommendationsGraded Prognostic Assessment (GPA) for Patients With Lung Cancer and Brain Metastases: Initial Report of the Small Cell Lung Cancer GPA and Update of the Non-Small Cell Lung Cancer GPA Including the Effect of Programmed Death Ligand 1 and Other Prognostic Factors
Sperduto PW, De B, Li J, Carpenter D, Kirkpatrick J, Milligan M, Shih HA, Kutuk T, Kotecha R, Higaki H, Otsuka M, Aoyama H, Bourgoin M, Roberge D, Dajani S, Sachdev S, Gainey J, Buatti JM, Breen W, Brown PD, Ni L, Braunstein S, Gallitto M, Wang TJC, Shanley R, Lou E, Shiao J, Gaspar LE, Tanabe S, Nakano T, An Y, Chiang V, Zeng L, Soliman H, Elhalawani H, Cagney D, Thomas E, Boggs DH, Ahluwalia MS, Mehta MP. Graded Prognostic Assessment (GPA) for Patients With Lung Cancer and Brain Metastases: Initial Report of the Small Cell Lung Cancer GPA and Update of the Non-Small Cell Lung Cancer GPA Including the Effect of Programmed Death Ligand 1 and Other Prognostic Factors. International Journal Of Radiation Oncology • Biology • Physics 2022, 114: 60-74. PMID: 35331827, PMCID: PMC9378572, DOI: 10.1016/j.ijrobp.2022.03.020.Peer-Reviewed Original ResearchConceptsNon-small cell lung cancerSmall cell lung cancerGraded Prognostic AssessmentBrain metastasesSignificant prognostic factorsPrognostic factorsDeath ligand 1Cell lung cancerLung cancerPD-L1Lung adenocarcinomaMedian survivalNSCLC adenocarcinomaPrognostic assessmentInitial reportMulti-institutional retrospective databaseProgrammed Death Ligand 1PD-L1 1Tumor molecular statusOverall median survivalPD-L1 expressionLigand 1Anaplastic lymphoma kinaseEpidermal growth factor receptorGrowth factor receptor
2021
Spatially resolved analysis of the T cell immune contexture in lung cancer-associated brain metastases
Lu BY, Gupta R, Aguirre-Ducler A, Gianino N, Wyatt H, Ribeiro M, Chiang VL, Contessa JN, Adeniran AJ, Jilaveanu LB, Kluger HM, Schalper KA, Goldberg SB. Spatially resolved analysis of the T cell immune contexture in lung cancer-associated brain metastases. Journal For ImmunoTherapy Of Cancer 2021, 9: e002684. PMID: 34670827, PMCID: PMC8529973, DOI: 10.1136/jitc-2021-002684.Peer-Reviewed Original ResearchConceptsPrimary lung tumorsT cell subsetsMajor T cell subsetsMultiplexed quantitative immunofluorescenceLung tumorsT cellsCoinhibitory receptorsTim-3Cell subsetsBrain metastasesQuantitative immunofluorescenceHigh LAG-3 expressionTumor PD-L1 expressionPD-L1 protein expressionLymphocyte activation gene-3Low T cell infiltrationHigh TIM-3Major clinicopathological variablesPD-L1 expressionLAG-3 expressionT cell infiltrationTumor-infiltrating lymphocytesLonger overall survivalCell death 1Tumor immune microenvironmentReirradiation With Stereotactic Radiosurgery After Local or Marginal Recurrence of Brain Metastases From Previous Radiosurgery
Kowalchuk RO, Niranjan A, Lee CC, Yang HC, Liscak R, Guseynova K, Tripathi M, Kumar N, Peker S, Samanci Y, Hess J, Chiang V, Iorio-Morin C, Mathieu D, Pikis S, Wei Z, Lunsford LD, Trifiletti DM, Sheehan JP. Reirradiation With Stereotactic Radiosurgery After Local or Marginal Recurrence of Brain Metastases From Previous Radiosurgery. International Journal Of Radiation Oncology • Biology • Physics 2021, 112: 726-734. PMID: 34644606, DOI: 10.1016/j.ijrobp.2021.10.008.Peer-Reviewed Original ResearchConceptsLocal tumor controlRepeat stereotactic radiosurgeryRadiation necrosisStereotactic radiosurgeryBrain metastasesTumor controlMaximum doseMarginal recurrenceBiopsy-proven non-small cell lung cancerIsodose lineNon-small cell lung cancerRisk of RNPreoperative stereotactic radiosurgeryPrior stereotactic radiosurgerySymptomatic radiation necrosisNeuro-Oncology criteriaCell lung cancerPrescription isodose linePrevious radiosurgeryMargin dosePrimary endpointPrior immunotherapyLung cancerMajor indicationTumor volumeAdverse radiation effects in volume-staged radiosurgery for large arteriovenous malformations: a multiinstitutional study.
Seymour ZA, Chan JW, McDermott MW, Grills I, Ye H, Kano H, Lehocky CA, Jacobs RC, Lunsford LD, Chytka T, Liščák R, Lee CC, Yang HC, Ding D, Sheehan JP, Feliciano CE, Rodriguez-Mercado R, Chiang VL, Hess JA, Sommaruga S, McShane B, Lee JYK, Vasas LT, Kaufmann AM, Sneed PK. Adverse radiation effects in volume-staged radiosurgery for large arteriovenous malformations: a multiinstitutional study. Journal Of Neurosurgery 2021, 136: 503-511. PMID: 34450589, DOI: 10.3171/2020.12.jns201866.Peer-Reviewed Original ResearchConceptsAdverse radiation effectsLarge arteriovenous malformationsArteriovenous malformationsVS-SRSLobe involvementSymptomatic adverse radiation effectsVolume-staged stereotactic radiosurgeryMedian margin doseOptimal treatment paradigmAVM nidus volumeTemporal lobe involvementVolume-staged radiosurgeryParietal lobe involvementMultiinstitutional cohortRadiosurgical centersMargin doseMedian ageRetrospective reviewEntire nidusMaximal linear dimensionMultiinstitutional studyNidus volumeTreatment paradigmStereotactic radiosurgeryPatientsIncidence and characteristics of metastatic intracranial lesions in stage III and IV melanoma: a single institute retrospective analysis
Sandhu MRS, Chiang VL, Tran T, Yu JB, Weiss S, Goldberg S, Aboian M, Kluger HM, Mahajan A. Incidence and characteristics of metastatic intracranial lesions in stage III and IV melanoma: a single institute retrospective analysis. Journal Of Neuro-Oncology 2021, 154: 197-203. PMID: 34351544, DOI: 10.1007/s11060-021-03813-8.Peer-Reviewed Original ResearchConceptsStage IV melanomaMetastatic brain lesionsStage IIIInitial diagnosisTumor RegistryOverall incidenceBrain lesionsBM incidenceSingle-institute retrospective analysisBM developmentBrain metastases incidenceIncidence of BMInstitution's tumor registryStage III patientsTime of diagnosisMetastatic intracranial lesionsCommon genetic mutationsTumor genetic profileGenetic profileBM occurrenceMedian durationAdvanced melanomaSurveillance regimenIII patientsMedian timeCommentary: Feasibility and Morbidity of Magnetic Resonance Imaging-Guided Stereotactic Laser Ablation of Deep Cerebral Cavernous Malformations: A Report of 4 Cases
Robert SM, Chiang VL. Commentary: Feasibility and Morbidity of Magnetic Resonance Imaging-Guided Stereotactic Laser Ablation of Deep Cerebral Cavernous Malformations: A Report of 4 Cases. Neurosurgery 2021, 89: e209-e210. PMID: 34293138, DOI: 10.1093/neuros/nyab262.Peer-Reviewed Original ResearchOutcomes of Stereotactic Radiosurgery and Immunotherapy in Renal Cell Carcinoma Patients With Brain Metastases
Uezono H, Nam D, Kluger HM, Sznol M, Hurwitz M, Yu JB, Chiang VL. Outcomes of Stereotactic Radiosurgery and Immunotherapy in Renal Cell Carcinoma Patients With Brain Metastases. American Journal Of Clinical Oncology 2021, 44: 495-501. PMID: 34432667, DOI: 10.1097/coc.0000000000000849.Peer-Reviewed Original ResearchConceptsImmune checkpoint inhibitorsRCC brain metastasesBrain metastasesRenal cell carcinomaStereotactic radiosurgeryOverall survivalUse of ICIsCentral nervous system toxicityRenal cell carcinoma patientsImpact of immunotherapyLocal control outcomesMedian overall survivalCell carcinoma patientsKaplan-Meier curvesNervous system toxicityBetter median OSLog-rank testMann-Whitney U testMargin doseMedian OSNonimmunotherapy groupSRS doseCheckpoint inhibitorsImmunotherapy groupCarcinoma patientsComparison of radiomic feature aggregation methods for patients with multiple tumors
Chang E, Joel MZ, Chang HY, Du J, Khanna O, Omuro A, Chiang V, Aneja S. Comparison of radiomic feature aggregation methods for patients with multiple tumors. Scientific Reports 2021, 11: 9758. PMID: 33963236, PMCID: PMC8105371, DOI: 10.1038/s41598-021-89114-6.Peer-Reviewed Original ResearchConceptsCox proportional hazards modelCox proportional hazardsProportional hazards modelBrain metastasesRadiomic featuresHazards modelProportional hazardsStandard Cox proportional hazards modelMultifocal brain metastasesMultiple brain metastasesNumber of patientsPatient-level outcomesHigher concordance indexRadiomic feature analysisRandom survival forest modelSurvival modelsDifferent tumor volumesMultifocal tumorsCancer outcomesMultiple tumorsMetastatic cancerConcordance indexTumor volumePatientsTumor typesTumor DNA Mutations From Intraparenchymal Brain Metastases Are Detectable in CSF
Cheok SK, Narayan A, Arnal-Estape A, Gettinger S, Goldberg SB, Kluger HM, Nguyen D, Patel A, Chiang V. Tumor DNA Mutations From Intraparenchymal Brain Metastases Are Detectable in CSF. JCO Precision Oncology 2021, 5: 163-172. PMID: 34250381, PMCID: PMC8232069, DOI: 10.1200/po.20.00292.Peer-Reviewed Original ResearchConceptsIntraparenchymal brain metastasesBrain metastasesCell-free DNAExtracranial tumorsBrain metastasis tissuesProgressive brain metastasesThird of patientsNormal pressure hydrocephalusTumor DNA mutationsPrimary cancer typeAnalysis of CSFSamples of CSFLeptomeningeal diseaseEffective surrogate markerBrain biopsyPressure hydrocephalusLumbar punctureSurrogate markerCancer-associated genesMetastasis tissuesPatientsMetastasisDiscordant responsesRenal cellsGenomic profiling
2020
A prospective multicenter study of laser ablation for drug resistant epilepsy – One year outcomes
Landazuri P, Shih J, Leuthardt E, Ben-Haim S, Neimat J, Tovar-Spinoza Z, Chiang V, Spencer D, Sun D, Fecci P, Baumgartner J. A prospective multicenter study of laser ablation for drug resistant epilepsy – One year outcomes. Epilepsy Research 2020, 167: 106473. PMID: 33045664, DOI: 10.1016/j.eplepsyres.2020.106473.Peer-Reviewed Original ResearchConceptsMesial temporal lobe epilepsyLaser interstitial thermal therapySeizure outcomeLife scoresPotential clinical characteristicsMulti-center registryDrug-resistant epilepsyProspective multicenter studyEffective treatment optionTemporal lobe epilepsyFocal cortical dysplasiaSocial functioning scoresInterstitial thermal therapyEngel IPain scoresAdverse eventsClinical characteristicsSeizure worryEpilepsy typeResistant epilepsySurgical treatmentShorter hospitalizationCortical dysplasiaHypothalamic hamartomaLobe epilepsySurvival in Patients With Brain Metastases: Summary Report on the Updated Diagnosis-Specific Graded Prognostic Assessment and Definition of the Eligibility Quotient.
Sperduto PW, Mesko S, Li J, Cagney D, Aizer A, Lin NU, Nesbit E, Kruser TJ, Chan J, Braunstein S, Lee J, Kirkpatrick JP, Breen W, Brown PD, Shi D, Shih HA, Soliman H, Sahgal A, Shanley R, Sperduto WA, Lou E, Everett A, Boggs DH, Masucci L, Roberge D, Remick J, Plichta K, Buatti JM, Jain S, Gaspar LE, Wu CC, Wang TJC, Bryant J, Chuong M, An Y, Chiang V, Nakano T, Aoyama H, Mehta MP. Survival in Patients With Brain Metastases: Summary Report on the Updated Diagnosis-Specific Graded Prognostic Assessment and Definition of the Eligibility Quotient. Journal Of Clinical Oncology 2020, 38: 3773-3784. PMID: 32931399, PMCID: PMC7655019, DOI: 10.1200/jco.20.01255.Peer-Reviewed Original ResearchConceptsGraded Prognostic AssessmentDiagnosis-Specific Graded Prognostic AssessmentBrain metastasesPrognostic factorsClinical trialsPrognostic assessmentLarge contemporary cohortSignificant prognostic factorsEnrollment of patientsNew prognostic factorsMulti-institutional databaseMedian survivalMultivariable analysisContemporary cohortWorse prognosisCell lungIndividualize treatmentTreatment choicePoor survivalRenal cancerPatientsPromising treatmentExpansion of eligibilityMetastasisPrimary siteExecutive summary from American Radium Society’s appropriate use criteria on neurocognition after stereotactic radiosurgery for multiple brain metastases
Milano MT, Chiang VLS, Soltys SG, Wang TJC, Lo SS, Brackett A, Nagpal S, Chao S, Garg AK, Jabbari S, Halasz LM, Gephart MH, Knisely JPS, Sahgal A, Chang EL. Executive summary from American Radium Society’s appropriate use criteria on neurocognition after stereotactic radiosurgery for multiple brain metastases. Neuro-Oncology 2020, 22: 1728-1741. PMID: 32780818, PMCID: PMC7746939, DOI: 10.1093/neuonc/noaa192.Peer-Reviewed Original ResearchConceptsWhole brain radiotherapyAsymptomatic brain metastasesGood performance statusBrain metastasesMultiple brain metastasesAppropriate use criteriaStereotactic radiosurgeryPerformance statusTreatment optionsAmerican Radium Society Appropriate Use CriteriaHippocampal Sparing-Whole Brain RadiotherapySystematic reviewConventional whole brain radiotherapySingle-fraction stereotactic radiosurgeryProgressive extracranial diseasePoor performance statusAppropriate treatment optionsQuality of evidenceBrainstem metastasesExtracranial diseaseConsensus guidelinesOptimal treatmentSystemic optionsNeurocognitive outcomesPatients