2020
Laser interstitial thermal therapy for treatment of cerebral radiation necrosis
Hong CS, Beckta JM, Kundishora AJ, Elsamadicy AA, Chiang VL. Laser interstitial thermal therapy for treatment of cerebral radiation necrosis. International Journal Of Hyperthermia 2020, 37: 68-76. PMID: 32672119, DOI: 10.1080/02656736.2020.1760362.Peer-Reviewed Original ResearchMeSH KeywordsBrain NeoplasmsHumansHyperthermia, InducedLaser TherapyLasersNecrosisNeoplasm Recurrence, LocalRadiation InjuriesRadiosurgeryConceptsLaser interstitial thermal therapyInterstitial thermal therapyRadiation necrosisRecurrent tumorsCerebral radiation necrosisPeri-operative morbidityBrain metastasis patientsFirst-line therapyAlternative surgical optionReal-time imaging guidanceOpen surgical resectionPersistence of symptomsTreatment of patientsDeep-seated lesionsTissue inflammatory responseAmenable lesionsChronic steroidsBrain metastasesMetastasis patientsSurgical resectionSymptomatic patientsMedical managementSurgical optionsSurgical historyIntracranial pathologyLaser interstitial thermal therapy (LITT) vs. bevacizumab for radiation necrosis in previously irradiated brain metastases
Sujijantarat N, Hong CS, Owusu KA, Elsamadicy AA, Antonios JP, Koo AB, Baehring JM, Chiang VL. Laser interstitial thermal therapy (LITT) vs. bevacizumab for radiation necrosis in previously irradiated brain metastases. Journal Of Neuro-Oncology 2020, 148: 641-649. PMID: 32602021, DOI: 10.1007/s11060-020-03570-0.Peer-Reviewed Original ResearchConceptsLaser interstitial thermal therapyLonger overall survivalRadiation necrosisInterstitial thermal therapyBrain metastasesOverall survivalMedian volume decreaseMedian volume increaseBrain metastasis patientsPre-treatment patient characteristicsRetrospective chart reviewResultsTwenty-five patientsPre-treatment factorsBevacizumab patientsChart reviewMetastasis patientsLocal recurrencePatient characteristicsTreatment optionsTreatment responseBevacizumabPatientsLesional volumeThermal therapyStatistical significanceMRI-Guided Laser Interstitial Thermal Therapy for Radiation Necrosis in Previously Irradiated Brain Arteriovenous Malformations
Hong CS, Cord BJ, Kundishora AJ, Elsamadicy AA, Beckta JM, Huttner A, Chiang VL, Matouk CC. MRI-Guided Laser Interstitial Thermal Therapy for Radiation Necrosis in Previously Irradiated Brain Arteriovenous Malformations. Practical Radiation Oncology 2020, 10: e298-e303. PMID: 32068154, DOI: 10.1016/j.prro.2020.02.003.Peer-Reviewed Original Research[11C]Methionine and [11C]PBR28 as PET Imaging Tracers to Differentiate Metastatic Tumor Recurrence or Radiation Necrosis
Tran TT, Gallezot JD, Jilaveanu LB, Zito C, Turcu G, Lim K, Nabulsi N, Huang H, Huttner A, Kluger HM, Chiang VL, Carson R. [11C]Methionine and [11C]PBR28 as PET Imaging Tracers to Differentiate Metastatic Tumor Recurrence or Radiation Necrosis. Molecular Imaging 2020, 19: 1536012120968669. PMID: 33147119, PMCID: PMC7649862, DOI: 10.1177/1536012120968669.Peer-Reviewed Original ResearchMeSH KeywordsBrain NeoplasmsHumansMethionineNecrosisNeoplasm Recurrence, LocalPositron-Emission TomographyRadiation InjuriesReceptors, GABAConceptsRadiation necrosisTumor regrowthStereotactic radiosurgeryBrain metastasesPET tracersHigh amino acid uptakeMetastatic tumor recurrenceLung cancer cellsSpecific PET tracersPET imaging tracerTumor recurrenceAmino acid uptakeImaging tracerReliable markerDiagnostic imagingLack of specificityAcid uptakeCancer cellsSpecific markersMethionine levelsTranslocator proteinSequential imagingInflammationMetastasisDual tracer
2019
Frequent Use of Local Therapy Underscores Need for Multidisciplinary Care in the Management of Patients With Melanoma Brain Metastases Treated With PD-1 Inhibitors
Qian JM, Yu JB, Mahajan A, Goldberg SB, Kluger HM, Chiang VLS. Frequent Use of Local Therapy Underscores Need for Multidisciplinary Care in the Management of Patients With Melanoma Brain Metastases Treated With PD-1 Inhibitors. International Journal Of Radiation Oncology • Biology • Physics 2019, 105: 1113-1118. PMID: 31479702, DOI: 10.1016/j.ijrobp.2019.08.053.Peer-Reviewed Original ResearchConceptsBrain metastasesLocal therapyNeurologic safetyMelanoma patientsProspective phase 2 trialProgressive brain metastasesSerial brain imagingMelanoma brain metastasesPD-1 inhibitorsPhase 2 trialRapid disease progressionManagement of patientsNeurologic symptomsMultidisciplinary careTrial enrollmentCystic changesClinical trialsDisease progressionPatientsLesion sizeMetastasisMultidisciplinary teamTumor growthTherapyClinical decisionAdverse Radiation Effects
Cheok SK, Chiang VL. Adverse Radiation Effects. Progress In Neurological Surgery 2019, 34: 138-148. PMID: 31096237, DOI: 10.1159/000493058.Peer-Reviewed Original ResearchLaser-interstitial thermal therapy compared to craniotomy for treatment of radiation necrosis or recurrent tumor in brain metastases failing radiosurgery
Hong CS, Deng D, Vera A, Chiang VL. Laser-interstitial thermal therapy compared to craniotomy for treatment of radiation necrosis or recurrent tumor in brain metastases failing radiosurgery. Journal Of Neuro-Oncology 2019, 142: 309-317. PMID: 30656529, DOI: 10.1007/s11060-019-03097-z.Peer-Reviewed Original ResearchConceptsLaser interstitial thermal therapyProgression-free survivalBrain metastasesRadiation necrosisOverall survivalStereotactic radiosurgeryRecurrent tumorsSingle-institution chart reviewPost-operative salvageResultsOf 75 patientsPre-operative symptomsViable alternative treatmentRe-growing tumorSteroid taperNeurological outcomeChart reviewSymptom reliefUnderwent craniotomySubgroup analysisTumor lesionsAlternative treatmentCraniotomyLocal controlMetastasisPatients
2018
Single versus Multifraction Stereotactic Radiosurgery for Large Brain Metastases: An International Meta-analysis of 24 Trials
Lehrer EJ, Peterson JL, Zaorsky NG, Brown PD, Sahgal A, Chiang VL, Chao ST, Sheehan JP, Trifiletti DM. Single versus Multifraction Stereotactic Radiosurgery for Large Brain Metastases: An International Meta-analysis of 24 Trials. International Journal Of Radiation Oncology • Biology • Physics 2018, 103: 618-630. PMID: 30395902, DOI: 10.1016/j.ijrobp.2018.10.038.Peer-Reviewed Original ResearchConceptsLarge brain metastasesMF-SRSSF-SRSMultifraction stereotactic radiosurgeryBrain metastasesRandom effects estimatesStereotactic radiosurgeryLocal controlMeta-AnalysisEffect estimatesRates of radionecrosisProspective clinical trialsPreferred Reporting ItemsRadionecrosis ratePostoperative settingTumor sizeInternational Meta-AnalysisEpidemiology guidelinesClinical trialsObservational studyRandom effectsTumor volumeSummary estimatesReporting ItemsMetastasisLaser ablation after stereotactic radiosurgery: a multicenter prospective study in patients with metastatic brain tumors and radiation necrosis.
Ahluwalia M, Barnett GH, Deng D, Tatter SB, Laxton AW, Mohammadi AM, Leuthardt E, Chamoun R, Judy K, Asher A, Essig M, Dietrich J, Chiang VL. Laser ablation after stereotactic radiosurgery: a multicenter prospective study in patients with metastatic brain tumors and radiation necrosis. Journal Of Neurosurgery 2018, 130: 804-811. PMID: 29726782, DOI: 10.3171/2017.11.jns171273.Peer-Reviewed Original ResearchMeSH KeywordsAblation TechniquesAdultAgedBrain NeoplasmsFemaleHumansKarnofsky Performance StatusLaser TherapyMagnetic Resonance ImagingMaleMiddle AgedNecrosisNeoplasm Recurrence, LocalPostoperative ComplicationsProgression-Free SurvivalProspective StudiesQuality of LifeRadiation InjuriesRadiosurgeryTreatment OutcomeConceptsProgression-free survivalQuality of lifeKarnofsky Performance ScaleMulticenter prospective studyKPS scoreRecurrent tumorsStereotactic radiosurgeryOverall survivalProspective studyRadiation necrosisNeuro-Oncology Brain Metastases criteriaLocal progression-free survivalMedian KPS scoreSteroid sparing effectMetastatic brain tumorsLength of stayPercent of subjectsDuration of survivalOverall event rateSignificant differencesMajority of casesMetastasis (TNM) criteriaOS advantageProgression patientsBrain metastases
2016
Novel biomarker identification using metabolomic profiling to differentiate radiation necrosis and recurrent tumor following Gamma Knife radiosurgery.
Lu AY, Turban JL, Damisah EC, Li J, Alomari AK, Eid T, Vortmeyer AO, Chiang VL. Novel biomarker identification using metabolomic profiling to differentiate radiation necrosis and recurrent tumor following Gamma Knife radiosurgery. Journal Of Neurosurgery 2016, 127: 388-396. PMID: 27885954, DOI: 10.3171/2016.8.jns161395.Peer-Reviewed Original ResearchConceptsGamma knife radiosurgeryRadiation necrosisRecurrent tumorsKnife radiosurgeryBrain metastasesSamples of tumorMetabolic imaging techniquesMetabolite profilesUnique metabolite profilesNovel biomarker identificationBrain biopsyPure tumorEnhancing lesionsSurgical biopsyLevels of metabolitesTumorsNecrosisTumor samplesDifferential metabolite profilesElevated levelsRadiosurgeryNoninvasive imagingComparison groupTissue samplesMetabolomic profilingPossible Interaction of Anti–PD-1 Therapy with the Effects of Radiosurgery on Brain Metastases
Alomari AK, Cohen J, Vortmeyer AO, Chiang A, Gettinger S, Goldberg S, Kluger HM, Chiang VL. Possible Interaction of Anti–PD-1 Therapy with the Effects of Radiosurgery on Brain Metastases. Cancer Immunology Research 2016, 4: 481-487. PMID: 26994250, DOI: 10.1158/2326-6066.cir-15-0238.Peer-Reviewed Original ResearchConceptsStereotactic radiosurgeryBrain metastasesInitiation of immunotherapyPD-1 mAbImmune-modulating therapyModalities of treatmentRadiologic progressionSurgical resectionSystemic therapyDeath-1Radiologic findingsMetastatic malignancyReactive astrocytosisPathologic examinationTreatment regimensHistopathologic examinationWall infiltrationT lymphocytesPatientsTumor progressionMonoclonal antibodiesBiologic interactionsRadiation-induced changesImmunotherapyMalignancy
2015
Does immunotherapy increase the rate of radiation necrosis after radiosurgical treatment of brain metastases?
Colaco RJ, Martin P, Kluger HM, Yu JB, Chiang VL. Does immunotherapy increase the rate of radiation necrosis after radiosurgical treatment of brain metastases? Journal Of Neurosurgery 2015, 125: 17-23. PMID: 26544782, DOI: 10.3171/2015.6.jns142763.Peer-Reviewed Original ResearchConceptsTreatment-related imaging changesCytotoxic chemotherapyRadiation necrosisBrain metastasesSystemic therapyStereotactic Gamma Knife radiosurgeryMedian overall survivalGamma knife radiosurgeryHigh-dose radiationChemotherapy eraGK surgeryImmunotherapy increasesMedian followConclusions PatientsOverall survivalImaging changesGK treatmentKnife radiosurgeryInflammatory reactionStereotactic radiosurgeryLower riskRadiosurgical treatmentPatientsImmunotherapyTherapy
2013
Stereotactic laser induced thermotherapy (LITT): a novel treatment for brain lesions regrowing after radiosurgery
Torres-Reveron J, Tomasiewicz HC, Shetty A, Amankulor NM, Chiang VL. Stereotactic laser induced thermotherapy (LITT): a novel treatment for brain lesions regrowing after radiosurgery. Journal Of Neuro-Oncology 2013, 113: 495-503. PMID: 23677747, DOI: 10.1007/s11060-013-1142-2.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBrain NeoplasmsFeasibility StudiesFemaleFollow-Up StudiesHumansHyperthermia, InducedImaging, Three-DimensionalLaser TherapyMagnetic Resonance ImagingMaleMiddle AgedNeoplasm Recurrence, LocalNeoplasmsPostoperative ComplicationsPrognosisRadiation InjuriesRadiosurgerySurvival RateConceptsNeurological symptomsBrain metastasesTreatment optionsStereotactic radiosurgeryWhole-brain radiation therapyGamma Knife stereotactic radiosurgeryBrain radiation therapyInitial favorable responseProgressive neurological symptomsAdverse radiation effectsNovel treatment optionsCases steroidsOngoing steroidsSymptom controlPatient comorbiditiesSurgical resectionSymptomatic reliefMetastatic lesionsRecurrent edemaRadiation necrosisBiopsy resultsDisease burdenMinimal morbidityBrain lesionsThermocoagulation procedures