2021
Comparison 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 types
2020
Laser 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 significanceLaser Ablation of Abnormal Neurological Tissue Using Robotic NeuroBlate System (LAANTERN): 12-Month Outcomes and Quality of Life After Brain Tumor Ablation
Kim AH, Tatter S, Rao G, Prabhu S, Chen C, Fecci P, Chiang V, Smith K, Williams BJ, Mohammadi AM, Judy K, Sloan A, Tovar-Spinoza Z, Baumgartner J, Hadjipanayis C, Leuthardt EC. Laser Ablation of Abnormal Neurological Tissue Using Robotic NeuroBlate System (LAANTERN): 12-Month Outcomes and Quality of Life After Brain Tumor Ablation. Neurosurgery 2020, 87: e338-e346. PMID: 32315434, PMCID: PMC7534487, DOI: 10.1093/neuros/nyaa071.Peer-Reviewed Original ResearchConceptsKarnofsky performance scorePrimary tumorBaseline Karnofsky performance scoreCancer Therapy-BrainPostprocedure hospital stayReal-world registryPatient-reported QOLNeurological tissuesHigh-grade gliomasQuality of lifeReal-world outcomesBaseline comorbiditiesHospital stayAdverse eventsMost patientsOverall survivalMedian ageBrain tumor ablationRadiation necrosisPatient populationMetastatic cancerFunctional assessmentSurvival rateBaseline levelsQoL
2019
Local tumor response and survival outcomes after combined stereotactic radiosurgery and immunotherapy in non-small cell lung cancer with brain metastases.
Singh C, Qian JM, Yu JB, Chiang VL. Local tumor response and survival outcomes after combined stereotactic radiosurgery and immunotherapy in non-small cell lung cancer with brain metastases. Journal Of Neurosurgery 2019, 132: 512-517. PMID: 30771783, DOI: 10.3171/2018.10.jns181371.Peer-Reviewed Original ResearchConceptsAnti-PD-1 therapyKarnofsky performance statusBrain metastasesLung cancer patientsStereotactic radiosurgeryCT groupIT groupCancer patientsNon-small cell lung cancer patientsNon-small cell lung cancerCell lung cancer patientsAntibody-positive patientsGraded Prognostic AssessmentCox regression analysisCell lung cancerMedian survival timeLocal tumor responseWhole study groupMann-Whitney U testTerms of survivalLesional responseMedian survivalPerformance statusWorse survivalComplete response
2018
Upfront Magnetic Resonance Imaging-Guided Stereotactic Laser-Ablation in Newly Diagnosed Glioblastoma: A Multicenter Review of Survival Outcomes Compared to a Matched Cohort of Biopsy-Only Patients.
Mohammadi AM, Sharma M, Beaumont TL, Juarez KO, Kemeny H, Dechant C, Seas A, Sarmey N, Lee BS, Jia X, Fecci PE, Baehring J, Moliterno J, Chiang VL, Ahluwalia MS, Kim AH, Barnett GH, Leuthardt EC. Upfront Magnetic Resonance Imaging-Guided Stereotactic Laser-Ablation in Newly Diagnosed Glioblastoma: A Multicenter Review of Survival Outcomes Compared to a Matched Cohort of Biopsy-Only Patients. Neurosurgery 2018, 85: 762-772. PMID: 30476325, PMCID: PMC7054708, DOI: 10.1093/neuros/nyy449.Peer-Reviewed Original ResearchConceptsProgression-free survivalDisease-specific deathOverall survivalChemo/radiotherapyPrognostic groupsOnly cohortNGBM patientsSpecific deathTumor volumeBiopsy-only patientsMedian tumor volumeFavorable prognostic factorRadiation/chemotherapyEffective treatment modalityStereotactic laser ablationMagnetic resonance imagingLA cohortMatched CohortMulticenter reviewPrognostic factorsUpfront treatmentIndependent predictorsSurvival outcomesTreatment modalitiesTumor locationEstimating survival for renal cell carcinoma patients with brain metastases: an update of the Renal Graded Prognostic Assessment tool
Sperduto PW, Deegan BJ, Li J, Jethwa KR, Brown PD, Lockney N, Beal K, Rana NG, Attia A, Tseng CL, Sahgal A, Shanley R, Sperduto WA, Lou E, Zahra A, Buatti JM, Yu JB, Chiang V, Molitoris JK, Masucci L, Roberge D, Shi DD, Shih HA, Olson A, Kirkpatrick JP, Braunstein S, Sneed P, Mehta MP. Estimating survival for renal cell carcinoma patients with brain metastases: an update of the Renal Graded Prognostic Assessment tool. Neuro-Oncology 2018, 20: 1652-1660. PMID: 30418657, PMCID: PMC6231200, DOI: 10.1093/neuonc/noy099.Peer-Reviewed Original ResearchConceptsPrognostic assessment toolsBrain metastasesRenal cell carcinomaMedian survivalPrognostic factorsAdditional significant prognostic factorsRenal cell carcinoma patientsRetrospective institutional review boardNew brain metastasesKarnofsky performance statusOverall median survivalCell carcinoma patientsSignificant prognostic factorsFuture clinical trialsClinical decision makingInstitutional review boardAssessment toolPerformance statusCommon complicationExtracranial metastasesHazard ratioCarcinoma patientsContemporary cohortRCC patientsWorse prognosis
2017
Improving the Prognostic Value of Disease-Specific Graded Prognostic Assessment Model for Renal Cell Carcinoma by Incorporation of Cumulative Intracranial Tumor Volume
Ali MA, Hirshman BR, Wilson B, Schupper AJ, Joshi R, Proudfoot JA, Goetsch SJ, Alksne JF, Ott K, Aiyama H, Nagano O, Carter BS, Chiang V, Serizawa T, Yamamoto M, Chen CC. Improving the Prognostic Value of Disease-Specific Graded Prognostic Assessment Model for Renal Cell Carcinoma by Incorporation of Cumulative Intracranial Tumor Volume. World Neurosurgery 2017, 108: 151-156. PMID: 28754641, PMCID: PMC5705321, DOI: 10.1016/j.wneu.2017.07.109.Peer-Reviewed Original ResearchConceptsCumulative intracranial tumor volumeNumber of BMKarnofsky performance scoreNet reclassification indexIntracranial tumor volumePrognostic assessment modelBrain metastasesPrognostic valueStereotactic radiosurgeryLogistic regression modelsTumor volumeMultivariable Cox proportional hazards modelsRenal cell carcinoma patientsUnivariable logistic regression modelsMultivariable logistic regression modelCox proportional hazards modelNew brain metastasesRCC brain metastasesCell carcinoma patientsImportant prognostic variablesRenal cell carcinomaProportional hazards modelRCC patient survivalBM patientsDS-GPALaser Thermal Ablation for Metastases Failing Radiosurgery: A Multicentered Retrospective Study
Chaunzwa TL, Deng D, Leuthardt EC, Tatter SB, Mohammadi AM, Barnett GH, Chiang VL. Laser Thermal Ablation for Metastases Failing Radiosurgery: A Multicentered Retrospective Study. Neurosurgery 2017, 82: 56-63. PMID: 28419284, DOI: 10.1093/neuros/nyx142.Peer-Reviewed Original ResearchConceptsRadiosurgical failureRadiation necrosisTumor regrowthAblation therapyFluid-attenuated inversion recovery signalTreatment factorsMulticentered retrospective studyKarnofsky performance statusMetastatic brain lesionsThermal ablation therapyLow complication rateTraditional treatment optionsTreatment of metastasesInversion recovery signalLaser thermal ablationBrain metastasesPreoperative symptomsComplication ratePerformance statusSymptomatic improvementSymptomatic reliefPerilesional edemaRetrospective studySurgical dataTreatment optionsManagement 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
The Effect of Gene Alterations and Tyrosine Kinase Inhibition on Survival and Cause of Death in Patients With Adenocarcinoma of the Lung and Brain Metastases
Sperduto PW, Yang TJ, Beal K, Pan H, Brown PD, Bangdiwala A, Shanley R, Yeh N, Gaspar LE, Braunstein S, Sneed P, Boyle J, Kirkpatrick JP, Mak KS, Shih HA, Engelman A, Roberge D, Arvold ND, Alexander B, Awad MM, Contessa J, Chiang V, Hardie J, Ma D, Lou E, Sperduto W, Mehta MP. The Effect of Gene Alterations and Tyrosine Kinase Inhibition on Survival and Cause of Death in Patients With Adenocarcinoma of the Lung and Brain Metastases. International Journal Of Radiation Oncology • Biology • Physics 2016, 96: 406-413. PMID: 27598807, PMCID: PMC5575932, DOI: 10.1016/j.ijrobp.2016.06.006.Peer-Reviewed Original ResearchMeSH KeywordsAdenocarcinomaAgedAged, 80 and overAnaplastic Lymphoma KinaseAntineoplastic AgentsBrain NeoplasmsErbB ReceptorsFemaleGenetic MarkersGenetic Predisposition to DiseaseHumansIncidenceLung NeoplasmsMaleMiddle AgedMutationPolymorphism, Single NucleotidePrevalenceProtein-Tyrosine KinasesReceptor Protein-Tyrosine KinasesRetrospective StudiesRisk FactorsSurvival RateUnited StatesConceptsTyrosine kinase inhibitionBrain metastasesMedian survivalCause of deathGene alterationsDiagnosis of BMMulti-institutional retrospective databaseTKI-naïve patientsRisk of deathLonger median survivalKinase inhibitionALK gene alterationsTreatment patternsCancer mortalityLung cancerPrimary diagnosisRetrospective databaseCommon causeLung adenocarcinomaGroup overallPatientsFirst treatmentPrior trialsEGFRMonthsTiming and type of immune checkpoint therapy affect the early radiographic response of melanoma brain metastases to stereotactic radiosurgery
Qian JM, Yu JB, Kluger HM, Chiang VL. Timing and type of immune checkpoint therapy affect the early radiographic response of melanoma brain metastases to stereotactic radiosurgery. Cancer 2016, 122: 3051-3058. PMID: 27285122, PMCID: PMC5030143, DOI: 10.1002/cncr.30138.Peer-Reviewed Original ResearchConceptsMedian percent reductionImmune checkpoint therapyLesional responseStereotactic radiosurgeryCheckpoint therapyLesion volumeAnti-cytotoxic T-lymphocyte-associated protein 4Anti-programmed cell death protein 1T-lymphocyte-associated protein 4Anti-PD-1 therapyGreater median percent reductionsCell death protein 1Administration of immunotherapyWeeks of immunotherapyMelanoma brain metastasesDeath protein 1Type of immunotherapyWilcoxon rank sum testRank sum testNonconcurrent therapyBrain metastasesMelanoma patientsTreatment of cancerSingle institutionPercent reductionPembrolizumab for patients with melanoma or non-small-cell lung cancer and untreated brain metastases: early analysis of a non-randomised, open-label, phase 2 trial
Goldberg SB, Gettinger SN, Mahajan A, Chiang AC, Herbst RS, Sznol M, Tsiouris AJ, Cohen J, Vortmeyer A, Jilaveanu L, Yu J, Hegde U, Speaker S, Madura M, Ralabate A, Rivera A, Rowen E, Gerrish H, Yao X, Chiang V, Kluger HM. Pembrolizumab for patients with melanoma or non-small-cell lung cancer and untreated brain metastases: early analysis of a non-randomised, open-label, phase 2 trial. The Lancet Oncology 2016, 17: 976-983. PMID: 27267608, PMCID: PMC5526047, DOI: 10.1016/s1470-2045(16)30053-5.Peer-Reviewed Original ResearchConceptsProgressive brain metastasesUntreated brain metastasesBrain metastasis responseYale Cancer CenterBrain metastasesPhase 2 trialCell lung cancerAdverse eventsMetastasis responseCancer CenterLung cancerMelanoma cohortGrade 3 colitisGrade 3 fatigueGrade 3 pneumonitisPD-1 axisAcute kidney injuryNeurological adverse eventsPD-1 inhibitorsAcceptable safety profilePD-L1 expressionSystemic immunotherapyKidney injuryPrimary endpointNSCLC cohort
2013
Survival and Intracranial Control of Patients With 5 or More Brain Metastases Treated With Gamma Knife Stereotactic Radiosurgery
Raldow AC, Chiang VL, Knisely JP, Yu JB. Survival and Intracranial Control of Patients With 5 or More Brain Metastases Treated With Gamma Knife Stereotactic Radiosurgery. American Journal Of Clinical Oncology 2013, 36: 486-490. PMID: 22706180, DOI: 10.1097/coc.0b013e31825494ef.Peer-Reviewed Original ResearchConceptsKarnofsky performance statusMore brain metastasesMedian overall survivalOverall survivalBrain metastasesRecurrence-free survivalStereotactic radiosurgeryWhole-brain radiation treatmentGamma Knife stereotactic radiosurgeryNumber of metastasesProportional hazards regressionGamma knife treatmentIntracranial controlOnly significant variableFree survivalIntracranial failurePerformance statusHazards regressionSurveillance imagingHistorical controlsDisease progressionRetrospective analysisPatientsFirst treatmentMetastasisStereotactic 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
2011
A Comprehensive Review of MR Imaging Changes following Radiosurgery to 500 Brain Metastases
Patel TR, McHugh BJ, Bi WL, Minja FJ, Knisely JP, Chiang VL. A Comprehensive Review of MR Imaging Changes following Radiosurgery to 500 Brain Metastases. American Journal Of Neuroradiology 2011, 32: 1885-1892. PMID: 21920854, PMCID: PMC7966021, DOI: 10.3174/ajnr.a2668.Peer-Reviewed Original ResearchConceptsBrain metastasesMedian survivalMetastatic lesionsLesion sizeMost metastatic lesionsMR imaging changesPercent of lesionsInitial treatment volumeSystemic cancer therapyInitial lesion sizeIntracranial metastatic lesionsGK-SRSLesional responsePatient demographicsRadiographic responseInitial treatmentImaging changesMale sexTumor sizeLesion volumeStereotactic radiosurgeryTreatment dosePatientsLesionsRadiosurgery
2008
Gamma Knife surgery for the treatment of melanoma metastases: the effect of intratumoral hemorrhage on survival.
Redmond AJ, DiLuna ML, Hebert R, Moliterno JA, Desai R, Knisely JP, Chiang VL. Gamma Knife surgery for the treatment of melanoma metastases: the effect of intratumoral hemorrhage on survival. Journal Of Neurosurgery 2008, 109 Suppl: 99-105. PMID: 19123895, DOI: 10.3171/jns/2008/109/12/s16.Peer-Reviewed Original ResearchConceptsGamma Knife surgeryMelanoma metastasesIntratumoral bleedingTime of GKSWhole-brain radiation therapyPost-GKS hemorrhageMelanoma brain metastasesRate of hemorrhageConnecticut Tumor RegistryMalignant melanoma metastaticSurvival of patientsTotal tumor volumeTreatment-specific factorsMelanoma metastaticPosttreatment bleedingAntithrombotic medicationBrain metastasesMetastasis locationOverall survivalSolitary metastasisTumor RegistryTumor burdenWorse prognosisIntracranial metastasesPatient survival
2006
Prognostic factors for survival after stereotactic radiosurgery vary with the number of cerebral metastases
DiLuna ML, King JT, Knisely JP, Chiang VL. Prognostic factors for survival after stereotactic radiosurgery vary with the number of cerebral metastases. Cancer 2006, 109: 135-145. PMID: 17133440, DOI: 10.1002/cncr.22367.Peer-Reviewed Original ResearchConceptsSubgroup of patientsStereotactic radiosurgeryBreast cancerGamma Knife stereotactic radiosurgeryNonsmall cell lung carcinomaCommon tumor histologyInitial stereotactic radiosurgeryWhole brain radiationConnecticut Tumor RegistryMultivariate survival analysisTotal tumor volumeCell lung carcinomaBrain metastasesCerebral metastasesMedian survivalMetastasis locationMedian agePrognostic factorsTumor RegistryTumor histologyIntracranial metastasesPatient populationEsophageal cancerIndependent associationLung carcinoma