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 results
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
2021
Reirradiation 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 ResearchMeSH KeywordsBrain NeoplasmsCarcinoma, Non-Small-Cell LungHumansLung NeoplasmsRadiosurgeryRe-IrradiationRetrospective StudiesConceptsLocal 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 radiosurgeryPatientsOutcomes 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 types
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 ResearchMeSH KeywordsBrain NeoplasmsCranial IrradiationHumansRadiosurgeryRadiumSystematic Reviews as TopicUnited StatesConceptsWhole 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 outcomesPatientsLaser 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 ResearchConceptsLaser 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 pathologyEvaluation 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 cohortLaser 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 Interstitial Thermotherapy for Treatment of Symptomatic Peritumoral Edema After Radiosurgery for Meningioma
Hong CS, Beckta JM, Kundishora AJ, Elsamadicy AA, Chiang VL. Laser Interstitial Thermotherapy for Treatment of Symptomatic Peritumoral Edema After Radiosurgery for Meningioma. World Neurosurgery 2020, 136: 295-300. PMID: 32001396, DOI: 10.1016/j.wneu.2020.01.143.Peer-Reviewed Original ResearchConceptsSymptomatic peritumoral edemaPeritumoral edemaLaser interstitial thermotherapySurgical resectionGrade IOpen surgical resectionEffective therapeutic modalityViable alternative treatmentInterstitial thermotherapyExperienced resolutionCorticosteroid therapyIntraoperative biopsyRefractory casesConservative managementMost patientsLesion recurrenceMedical therapyRadiation necrosisUnderlying lesionSurgical interventionWound infectionTherapeutic modalitiesRadiosurgical treatmentAlternative treatmentFrontotemporal lesions
2019
Dose response and architecture in volume staged radiosurgery for large arteriovenous malformations: A multi-institutional study
Seymour ZA, Chan JW, Sneed PK, Kano H, Lehocky CA, Jacobs RC, Ye H, Chytka T, Liscak R, Lee CC, Yang HC, Ding D, Sheehan J, Feliciano CE, Rodriguez-Mercado R, Chiang VL, Hess JA, Sommaruga S, McShane B, Lee J, Vasas LT, Kaufmann AM, Grills I, McDermott MW. Dose response and architecture in volume staged radiosurgery for large arteriovenous malformations: A multi-institutional study. Radiotherapy And Oncology 2019, 144: 180-188. PMID: 31835173, DOI: 10.1016/j.radonc.2019.09.019.Peer-Reviewed Original ResearchConceptsLarge arteriovenous malformationsArteriovenous malformationsVS-SRSMargin doseObliteration rateVolume-staged stereotactic radiosurgeryMedian margin doseHigh-risk lesionsOptimal treatment paradigmAVM nidus volumeMulti-institutional studyImproved ratesCompact nidusEvaluable patientsMedian followRadiosurgical centersOverall survivalUpfront treatmentComplete responseMedian ageRetrospective reviewCure rateRare lesionsPrior embolizationTreatment paradigmRole of Gamma Knife Radiosurgery in Small Cell Lung Cancer: A Multi-Institutional Retrospective Study of the International Radiosurgery Research Foundation (IRRF)
Cifarelli CP, Vargo JA, Fang W, Liscak R, Guseynova K, Warnick RE, Lee CC, Yang HC, Borghei-Razavi H, Maiti T, Siddiqui ZA, Yuan JC, Grills IS, Mathieu D, Touchette CJ, Cordeiro D, Chiang V, Hess J, Tien CJ, Faramand A, Kano H, Barnett GH, Sheehan JP, Lunsford LD. Role of Gamma Knife Radiosurgery in Small Cell Lung Cancer: A Multi-Institutional Retrospective Study of the International Radiosurgery Research Foundation (IRRF). Neurosurgery 2019, 87: 664-671. PMID: 31599324, PMCID: PMC7780439, DOI: 10.1093/neuros/nyz428.Peer-Reviewed Original ResearchConceptsSmall cell lung cancerWhole-brain irradiationSCLC brain metastasesInternational Radiosurgery Research FoundationDistant brain failureBrain metastasesOverall survivalStereotactic radiosurgerySCLC patientsBrain failureLung cancerPrior whole-brain irradiationMulti-institutional retrospective reviewKaplan-Meier survival analysisCox proportional hazards modelLocal failureProphylactic cranial irradiationInstitutional retrospective studyMedian marginal doseOngoing prospective trialsCell lung cancerGamma knife radiosurgeryInstitutional review boardValue of radiosurgeryBinary logistic regressionA Proposed Grading Scale for Predicting Outcomes After Stereotactic Radiosurgery for Dural Arteriovenous Fistulas
Mohammed N, Hung YC, Chen CJ, Xu Z, Schlesinger D, Kano H, Chiang V, Hess J, Lee J, Mathieu D, Kaufmann AM, Grills IS, Cifarelli CP, Vargo JA, Chytka T, Janouskova L, Feliciano CE, Mercado RR, Lunsford LD, Sheehan JP. A Proposed Grading Scale for Predicting Outcomes After Stereotactic Radiosurgery for Dural Arteriovenous Fistulas. Neurosurgery 2019, 87: 247-255. PMID: 31584074, PMCID: PMC7528658, DOI: 10.1093/neuros/nyz401.Peer-Reviewed Original ResearchConceptsDural arteriovenous fistulaCranial dural arteriovenous fistulasCortical venous refluxFavorable outcomeStereotactic radiosurgeryGrading systemIntracerebral hemorrhageArteriovenous fistulaScoring systemGrading scaleKaplan-Meier analysisPrior intracerebral hemorrhageClass II patientsLogistic regression analysisPractical grading systemDAVF obliterationVenous refluxII patientsClinical parametersSinus locationPredicting OutcomeSystematic reviewClass IIIPatientsROC analysisMulti-institutional validation of brain metastasis velocity, a recently defined predictor of outcomes following stereotactic radiosurgery
McTyre ER, Soike MH, Farris M, Ayala-Peacock DN, Hepel JT, Page BR, Shen C, Kleinberg L, Contessa JN, Corso C, Chiang V, Henson-Masters A, Cramer CK, Ruiz J, Pasche B, Watabe K, D'Agostino R, Su J, Laxton AW, Tatter SB, Fiveash JB, Ahluwalia M, Kotecha R, Chao ST, Braunstein SE, Attia A, Chung C, Chan MD. Multi-institutional validation of brain metastasis velocity, a recently defined predictor of outcomes following stereotactic radiosurgery. Radiotherapy And Oncology 2019, 142: 168-174. PMID: 31526671, DOI: 10.1016/j.radonc.2019.08.011.Peer-Reviewed Original ResearchConceptsBrain metastasis velocityDistant brain failureMedian overall survivalOverall survivalBrain metastasesPredictors of OSInitial brain metastasesNew brain metastasesWhole brain radiationKaplan-Meier methodHigh-risk groupPredictors of outcomeProportional hazards methodsMulti-institutional settingMulti-institutional validationMultivariate regression modelingInitial SRSBrain radiationSalvage modalityInitial treatmentBrain failureRecurrence rateValidation cohortBMV groupMelanoma histologyFrequent 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 ResearchStereotactic Laser Ablation as Treatment of Brain Metastases Recurring after Stereotactic Radiosurgery: A Systematic Literature Review
Alattar AA, Bartek J, Chiang VL, Mohammadi AM, Barnett GH, Sloan A, Chen CC. Stereotactic Laser Ablation as Treatment of Brain Metastases Recurring after Stereotactic Radiosurgery: A Systematic Literature Review. World Neurosurgery 2019, 128: 134-142. PMID: 31051303, DOI: 10.1016/j.wneu.2019.04.200.Peer-Reviewed Original ResearchMeSH KeywordsBrain NeoplasmsHumansLaser TherapyMetastasectomyNeoplasm Recurrence, LocalRadiosurgeryStereotaxic TechniquesConceptsStereotactic laser ablationLocal controlContrast-enhancing volumeBrain metastasesFluid-attenuated inversion recovery volumeMalignant cerebral edemaPermanent neurologic injuryPreoperative lesion volumeMedian hospital stayDuration of therapyPotential treatment optionPercentage of tumorsHours of treatmentHospital stayNeurologic outcomePeriprocedural managementCerebral edemaCommon complicationMedian survivalNeurologic deficitsNeurologic injuryOverall survivalClinical courseTreatment optionsOptimal treatment