2023
Selected-Lesion Stereotactic Radiosurgery (SL-SRS) as a Novel Strategy in the Treatment of Patients With Multiple Brain Metastases
Theriault B, Singh C, Yu J, Knisely J, Shepard M, Wegner R, Warnick R, Peker S, Samanci Y, Trifiletti D, Lee C, Yang H, Bernstein K, Kondziolka D, Tripathi M, Mathieu D, Mantziaris G, Pikis S, Sheehan J, Chiang V. Selected-Lesion Stereotactic Radiosurgery (SL-SRS) as a Novel Strategy in the Treatment of Patients With Multiple Brain Metastases. Cureus 2023, 15: e45457. PMID: 37859877, PMCID: PMC10583225, DOI: 10.7759/cureus.45457.Peer-Reviewed Original ResearchWhole brain radiotherapyInternational Radiosurgery Research FoundationPrior whole brain radiotherapyBrain metastasesStereotactic radiosurgeryCommon reasonAsymptomatic brain metastasesNon-eloquent locationsSystemic treatment optionsMultiple brain metastasesPoor functional statusTreatment of patientsCentral nervous systemAttributable symptomsExtracranial diseaseSystemic therapyUntreated lesionsMedical oncologySystemic diseaseFunctional statusTreatment optionsClinical trialsSingle lesionLesion locationIntracranial lesionsManagement of patients with brain metastases from NSCLC without a genetic driver alteration: upfront radiotherapy or immunotherapy?
Merkin R, Chiang V, Goldberg S. Management of patients with brain metastases from NSCLC without a genetic driver alteration: upfront radiotherapy or immunotherapy? Therapeutic Advances In Medical Oncology 2023, 15: 17588359231175438. PMID: 37275964, PMCID: PMC10233588, DOI: 10.1177/17588359231175438.Peer-Reviewed Original ResearchImmune checkpoint inhibitorsBrain metastasesTargetable genetic alterationsLocal therapyLung cancerStereotactic radiosurgeryDeath 1 ligand 1 expressionManagement of BMSole metastatic siteStage IV diseaseWhole brain radiotherapyLigand 1 expressionPD-L1 expressionProspective clinical trialsTime of diagnosisManagement of patientsCell lung cancerCancer-related deathGenetic alterationsCentral nervous systemGenetic driver alterationsAnaplastic lymphoma kinaseEpidermal growth factor receptorGrowth factor receptorUpfront radiotherapy
2022
Multicenter 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 options
2020
Executive 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 outcomesPatientsEvaluation of First-line Radiosurgery vs Whole-Brain Radiotherapy for Small Cell Lung Cancer Brain Metastases
Rusthoven CG, Yamamoto M, Bernhardt D, Smith DE, Gao D, Serizawa T, Yomo S, Aiyama H, Higuchi Y, Shuto T, Akabane A, Sato Y, Niranjan A, Faramand AM, Lunsford LD, McInerney J, Tuanquin LC, Zacharia BE, Chiang V, Singh C, Yu JB, Braunstein S, Mathieu D, Touchette CJ, Lee CC, Yang HC, Aizer AA, Cagney DN, Chan MD, Kondziolka D, Bernstein K, Silverman JS, Grills IS, Siddiqui ZA, Yuan JC, Sheehan JP, Cordeiro D, Nosaki K, Seto T, Deibert CP, Verma V, Day S, Halasz LM, Warnick RE, Trifiletti DM, Palmer JD, Attia A, Li B, Cifarelli CP, Brown PD, Vargo JA, Combs SE, Kessel KA, Rieken S, Patel S, Guckenberger M, Andratschke N, Kavanagh BD, Robin TP. Evaluation of First-line Radiosurgery vs Whole-Brain Radiotherapy for Small Cell Lung Cancer Brain Metastases. JAMA Oncology 2020, 6: 1028-1037. PMID: 32496550, PMCID: PMC7273318, DOI: 10.1001/jamaoncol.2020.1271.Peer-Reviewed Original ResearchConceptsWhole brain radiotherapyProgression-free survivalSmall-cell lung cancer (SCLC) brain metastasesCell lung cancer brain metastasesCNS progression-free survivalLung cancer brain metastasesPropensity score-matched analysisMedian overall survivalCancer brain metastasesBrain metastasesOverall survivalStereotactic radiosurgeryCentral nervous system (CNS) progression-free survivalMedian CNS progression-free survivalSRS outcomesCentral nervous system progressionSmall cell lung cancerLimited brain metastasesMulticenter cohort studyDisease control statusCell lung cancerSingle-arm trialStandard of careLeptomeningeal progressionWBRT cohortMulti-institutional retrospective review of stereotactic radiosurgery for brain metastasis in patients with small cell lung cancer without prior brain-directed radiotherapy.
Miccio JA, Barsky A, Gao S, Verma V, Noticewala SS, Jairam V, Johnson SB, Yu JB, Hansen JE, Aneja S, An Y, Decker RH, Bulent Omay S, Li J, Kurtz GA, Alonso-Basanta M, Lee JYK, Chiang VL, Park HS. Multi-institutional retrospective review of stereotactic radiosurgery for brain metastasis in patients with small cell lung cancer without prior brain-directed radiotherapy. Journal Of Radiosurgery And SBRT 2020, 7: 19-27. PMID: 32802575, PMCID: PMC7406345.Peer-Reviewed Original ResearchWhole brain radiotherapyBrain metastasesOverall survivalNeurologic deathSmall-cell lung cancer (SCLC) brain metastasesCell lung cancer brain metastasesLung cancer brain metastasesSalvage whole brain radiotherapyMulti-institutional retrospective reviewSmall cell lung cancerMost SCLC patientsSCLC brain metastasesTime of SRSMedian overall survivalCancer brain metastasesCell lung cancerIntracranial progressionSCLC patientsUpfront radiosurgeryBrain radiationBrain radiotherapySelect patientsRetrospective reviewLung cancerStereotactic radiosurgery
2018
Multi-institutional competing risks analysis of distant brain failure and salvage patterns after upfront radiosurgery without whole brain radiotherapy for brain metastasis
McTyre E, Ayala-Peacock D, Contessa J, Corso C, Chiang V, Chung C, Fiveash J, Ahluwalia M, Kotecha R, Chao S, Attia A, Henson A, Hepel J, Braunstein S, Chan M. Multi-institutional competing risks analysis of distant brain failure and salvage patterns after upfront radiosurgery without whole brain radiotherapy for brain metastasis. Annals Of Oncology 2018, 29: 497-503. PMID: 29161348, DOI: 10.1093/annonc/mdx740.Peer-Reviewed Original ResearchConceptsDistant brain failureWhole brain radiotherapyUpfront stereotactic radiosurgerySalvage whole brain radiotherapySalvage stereotactic radiosurgeryBrain metastasesStereotactic radiosurgerySystemic diseaseMultivariate analysisBrain radiotherapyBrain failureDecreased hazardMelanoma histologyProgressive systemic diseaseWidespread systemic diseaseSystemic disease statusLower KPSSRS doseUpfront radiosurgeryIncreased hazardCompeting Risk AnalysisEarly deathAcademic centersPatientsMetastasis
2017
Prediction of new brain metastases after radiosurgery: validation and analysis of performance of a multi-institutional nomogram
Ayala-Peacock DN, Attia A, Braunstein SE, Ahluwalia MS, Hepel J, Chung C, Contessa J, McTyre E, Peiffer AM, Lucas JT, Isom S, Pajewski NM, Kotecha R, Stavas MJ, Page BR, Kleinberg L, Shen C, Taylor RB, Onyeuku NE, Hyde AT, Gorovets D, Chao ST, Corso C, Ruiz J, Watabe K, Tatter SB, Zadeh G, Chiang VLS, Fiveash JB, Chan MD. Prediction of new brain metastases after radiosurgery: validation and analysis of performance of a multi-institutional nomogram. Journal Of Neuro-Oncology 2017, 135: 403-411. PMID: 28828698, PMCID: PMC5667906, DOI: 10.1007/s11060-017-2588-4.Peer-Reviewed Original ResearchConceptsDistant brain failureWhole brain radiotherapyNew brain metastasesBrain metastasesStereotactic radiosurgeryRisk of DBFEarly whole brain radiotherapyPrognostic modelUpfront whole brain radiotherapyMulti-institutional nomogramNumber of metastasesHigh-risk thresholdSRS monotherapyMargin doseBrain radiotherapyBrain failureContemporary cohortPrognostic indexMelanoma histologyRelative riskAcademic centersMetastasisPatientsValidation datasetAbsolute numberManagement of Brain Metastases in Tyrosine Kinase Inhibitor–Naïve Epidermal Growth Factor Receptor–Mutant Non–Small-Cell Lung Cancer: A Retrospective Multi-Institutional Analysis
Magnuson WJ, Lester-Coll NH, Wu AJ, Yang TJ, Lockney NA, Gerber NK, Beal K, Amini A, Patil T, Kavanagh BD, Camidge DR, Braunstein SE, Boreta LC, Balasubramanian SK, Ahluwalia MS, Rana NG, Attia A, Gettinger SN, Contessa JN, Yu JB, Chiang VL. Management of Brain Metastases in Tyrosine Kinase Inhibitor–Naïve Epidermal Growth Factor Receptor–Mutant Non–Small-Cell Lung Cancer: A Retrospective Multi-Institutional Analysis. Journal Of Clinical Oncology 2017, 35: jco.2016.69.714. PMID: 28113019, DOI: 10.1200/jco.2016.69.7144.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntineoplastic AgentsBrain NeoplasmsCarcinoma, Non-Small-Cell LungCombined Modality TherapyCranial IrradiationDisease-Free SurvivalErbB ReceptorsErlotinib HydrochlorideFemaleHumansLung NeoplasmsMaleMiddle AgedProtein Kinase InhibitorsRadiosurgeryRetrospective StudiesSalvage TherapySurvival RateConceptsWhole brain radiotherapyMulti-institutional analysisEGFR-mutant NSCLCBrain metastasesEGFR-TKIStereotactic radiosurgeryTyrosine kinase inhibitorsOverall survivalEpidermal growth factor receptorGrowth factor receptorIntracranial progressionLung cancerMutant non-small cell lung cancerEGFR-TKI resistance mutationNon-small cell lung cancerIntracranial progression-free survivalRetrospective multi-institutional analysisDeferral of radiotherapyEGFR-TKI useSimilar prognostic featuresUpfront EGFR-TKIProgression-free survivalFactor receptorInferior overall survivalCell lung cancer
2016
A contemporary dose selection algorithm for stereotactic radiosurgery in the treatment of brain metastases - An initial report.
Colaco RJ, Yu JB, Bond JS, Bindra RS, Contessa JN, Knisely JPS, Chiang VL. A contemporary dose selection algorithm for stereotactic radiosurgery in the treatment of brain metastases - An initial report. Journal Of Radiosurgery And SBRT 2016, 4: 43-52. PMID: 29296425, PMCID: PMC5658834.Peer-Reviewed Original ResearchWhole brain radiotherapyDistant intracranial recurrenceLocal recurrenceBrain metastasesRTOG 90Overall local recurrence ratePrevious whole-brain radiotherapyProspective phase 2 trialWhole-brain radiation therapyBrain radiation therapyLocal recurrence rateMonths overall survivalPhase 2 trialRisk regression analysisGuideline dosesBrain radiotherapyPrimary endpointIntracranial recurrenceOverall survivalFine-GrayPrescription dosesRecurrence rateRetrospective outcomesMedical recordsLesion volume
2015
Equivalent whole brain dose for patients undergoing gamma knife for multiple lesions.
Jairam V, Chiang VL, Bond J, Yu JB. Equivalent whole brain dose for patients undergoing gamma knife for multiple lesions. Journal Of Radiosurgery And SBRT 2015, 3: 187-191. PMID: 29296401, PMCID: PMC5746333.Peer-Reviewed Original ResearchWhole-brain doseTotal tumor volumeMultiple lesionsTumor volumeBrain doseMedian total tumor volumeCumulative tumor volumeWhole brain dosesWhole brain radiotherapyTreatment of patientsBrain metastasesBrain radiotherapyIndividualized treatment planningTumor numberBrain dosesInstitutional databaseTumor locationMedian numberRadiosurgical treatmentPatientsRepresentative patientsLesionsEntire brainVital structuresGamma Knife
2011
Stereotactic radiosurgery with or without whole-brain radiotherapy for brain metastases: an update
Park HS, Chiang VL, Knisely JP, Raldow AC, Yu JB. Stereotactic radiosurgery with or without whole-brain radiotherapy for brain metastases: an update. Expert Review Of Anticancer Therapy 2011, 11: 1731-1738. PMID: 22050022, DOI: 10.1586/era.11.165.Peer-Reviewed Original ResearchConceptsWhole-brain radiation therapyStereotactic radiosurgeryBrain metastasesAddition of SRSUse of SRSMD Anderson Cancer CenterWhole brain radiotherapyLocal tumor controlStandard of careAnderson Cancer CenterNormal brain tissueNonrandomized evidenceLimited metastasesOligometastatic diseaseCancer CenterTumor controlRelative sparingRadiation therapyBrain tissueMetastasisSingle fractionNormal tissuesPatientsRadiosurgeryTrials