2023
Local 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 ResearchMeSH KeywordsAdultAgedAged, 80 and overBrain NeoplasmsHumansKaplan-Meier EstimateMiddle AgedPrognosisRadiosurgeryRetrospective StudiesSurvival AnalysisTreatment OutcomeConceptsKarnofsky 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 primary
2021
Outcomes 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 patients
2019
Role 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 analysisInitial SRS for Patients With 5 to 15 Brain Metastases: Results of a Multi-Institutional Experience
Hughes RT, Masters AH, McTyre ER, Farris MK, Chung C, Page BR, Kleinberg LR, Hepel J, Contessa JN, Chiang V, Ruiz J, Watabe K, Su J, Fiveash JB, Braunstein S, Chao S, Attia A, Ayala-Peacock DN, Chan MD. Initial SRS for Patients With 5 to 15 Brain Metastases: Results of a Multi-Institutional Experience. International Journal Of Radiation Oncology • Biology • Physics 2019, 104: 1091-1098. PMID: 30959122, DOI: 10.1016/j.ijrobp.2019.03.052.Peer-Reviewed Original ResearchConceptsDistant brain failureInitial stereotactic radiosurgerySalvage whole brain radiation therapyWhole-brain radiation therapySalvage stereotactic radiosurgeryBrain metastasesBrain radiation therapyOverall survivalStereotactic radiosurgeryBM groupCumulative incidenceRadiation therapyNumber of BMTwo-year cumulative incidenceMultivariable Cox proportional hazardsBrain metastasis velocityMedian overall survivalOutcomes of patientsKaplan-Meier methodLog-rank testMulti-institutional experienceRisk regression modelingCox proportional hazardsMultivariable analysisNew metastasesSurvival and prognostic factors in patients with gastrointestinal cancers and brain metastases: have we made progress?
Sperduto PW, Fang P, Li J, Breen W, Brown PD, Cagney D, Aizer A, Yu J, Chiang V, Jain S, Gaspar LE, Myrehaug S, Sahgal A, Braunstein S, Sneed P, Cameron B, Attia A, Molitoris J, Wu CC, Wang TJC, Lockney N, Beal K, Parkhurst J, Buatti JM, Shanley R, Lou E, Tandberg DD, Kirkpatrick JP, Shi D, Shih HA, Chuong M, Saito H, Aoyama H, Masucci L, Roberge D, Mehta MP. Survival and prognostic factors in patients with gastrointestinal cancers and brain metastases: have we made progress? Translational Research 2019, 208: 63-72. PMID: 30885538, PMCID: PMC6527460, DOI: 10.1016/j.trsl.2019.02.011.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrain NeoplasmsCohort StudiesFemaleGastrointestinal NeoplasmsHumansKaplan-Meier EstimateMaleMiddle AgedPrognosisConceptsGI cancer patientsBrain metastasesGraded Prognostic AssessmentCancer patientsPrognostic factorsNew brain metastasesLarge contemporary cohortPrognosis of patientsLog-rank testMedian survival estimatesContemporary cohortPrognostic indexClinical parametersGastrointestinal cancerPrimary diagnosisPrognostic assessmentRetrospective IRBPatientsFirst treatmentDemographic dataSurvival estimatesCurrent cohortCohortTreatmentPrognosis
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 ResearchMeSH KeywordsAdultAgedBrain NeoplasmsFemaleHumansKaplan-Meier EstimateMaleMiddle AgedRadiosurgeryRisk FactorsSalvage TherapyConceptsDistant 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
Cumulative Intracranial Tumor Volume Augments the Prognostic Value of Diagnosis-Specific Graded Prognostic Assessment Model for Survival in Patients with Melanoma Cerebral Metastases
Hirshman BR, Wilson BR, Ali MA, Schupper AJ, Proudfoot JA, Goetsch SJ, Carter BS, Sinclair G, Bartek J, Chiang V, Fogarty G, Hong A, Chen CC. Cumulative Intracranial Tumor Volume Augments the Prognostic Value of Diagnosis-Specific Graded Prognostic Assessment Model for Survival in Patients with Melanoma Cerebral Metastases. Neurosurgery 2017, 83: 237-244. PMID: 28973506, DOI: 10.1093/neuros/nyx380.Peer-Reviewed Original ResearchConceptsCumulative intracranial tumor volumeIntracranial tumor volumeMelanoma brain metastasesBrain metastasesPrognostic valueDS-GPATumor volumeStereotactic radiosurgeryIndependent cohortKey prognostic variablesPrognostic assessment modelPrognostic assessment scaleKarnofsky performance statusNet reclassification indexCerebral metastasesPerformance statusMelanoma patientsPrognostic utilityIntracranial metastasesReclassification indexPrognostic accuracyPrognostic scalesPrognostic variablesPatientsMelanoma cohort
2015
Extended Survival and Prognostic Factors for Patients With ALK-Rearranged Non–Small-Cell Lung Cancer and Brain Metastasis
Johung KL, Yeh N, Desai NB, Williams TM, Lautenschlaeger T, Arvold ND, Ning MS, Attia A, Lovly CM, Goldberg S, Beal K, Yu JB, Kavanagh BD, Chiang VL, Camidge DR, Contessa JN. Extended Survival and Prognostic Factors for Patients With ALK-Rearranged Non–Small-Cell Lung Cancer and Brain Metastasis. Journal Of Clinical Oncology 2015, 34: 123-129. PMID: 26438117, PMCID: PMC5070549, DOI: 10.1200/jco.2015.62.0138.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnaplastic Lymphoma KinaseAntineoplastic AgentsBrain NeoplasmsCarbazolesCarcinoma, Non-Small-Cell LungCranial IrradiationCrizotinibDisease-Free SurvivalFemaleFollow-Up StudiesGene RearrangementHumansKaplan-Meier EstimateKarnofsky Performance StatusLung NeoplasmsMaleMiddle AgedMolecular Targeted TherapyNeoplasm StagingPiperidinesPrognosisProtein Kinase InhibitorsProtein-Tyrosine KinasesPyrazolesPyridinesPyrimidinesRadiosurgeryReceptor Protein-Tyrosine KinasesRisk AssessmentRisk FactorsSmokingSulfonesConceptsIntracranial progression-free survivalBrain metastasesProgression-free survivalPrognostic factorsLung cancerMedian intracranial progression-free survivalNon-small cell lung cancerTyrosine kinase inhibitor therapyProgressive brain metastasesRefinement of prognosisKarnofsky performance scorePercent of patientsClinical prognostic factorsPopulation of patientsSingle brain metastasisCell lung cancerKinase inhibitor therapyCox proportional hazardsMulti-institutional studyMedian OSExtracranial metastasesImproved survivalInhibitor therapyInitial treatmentMultivariable analysisCharacterization of PD-L1 Expression and Associated T-cell Infiltrates in Metastatic Melanoma Samples from Variable Anatomic Sites
Kluger HM, Zito CR, Barr ML, Baine MK, Chiang VL, Sznol M, Rimm DL, Chen L, Jilaveanu LB. Characterization of PD-L1 Expression and Associated T-cell Infiltrates in Metastatic Melanoma Samples from Variable Anatomic Sites. Clinical Cancer Research 2015, 21: 3052-3060. PMID: 25788491, PMCID: PMC4490112, DOI: 10.1158/1078-0432.ccr-14-3073.Peer-Reviewed Original ResearchConceptsPD-L1 expressionT-cell contentPD-1/PD-L1 inhibitorsHigher T-cell contentT-cell infiltratesPD-L1 inhibitorsAnatomic sitesBrain metastasesMetastatic melanomaTissue microarrayHigh PD-L1 expressionLess PD-L1 expressionLow PD-L1 expressionTumor PD-L1 expressionHigher TIL contentImproved overall survivalT cell infiltrationLess T cellsMetastatic melanoma samplesExtracerebral metastasesCerebral metastasesOverall survivalDermal metastasesImproved survivalPD-L1
2014
Gamma Knife radiosurgery for sellar and parasellar meningiomas: a multicenter study.
Sheehan JP, Starke RM, Kano H, Kaufmann AM, Mathieu D, Zeiler FA, West M, Chao ST, Varma G, Chiang VL, Yu JB, McBride HL, Nakaji P, Youssef E, Honea N, Rush S, Kondziolka D, Lee JY, Bailey RL, Kunwar S, Petti P, Lunsford LD. Gamma Knife radiosurgery for sellar and parasellar meningiomas: a multicenter study. Journal Of Neurosurgery 2014, 120: 1268-77. PMID: 24678777, DOI: 10.3171/2014.2.jns13139.Peer-Reviewed Original ResearchConceptsGamma knife radiosurgeryPrior radiation therapyParasellar meningiomasSellar meningiomasKnife radiosurgeryRadiation therapyPrior surgeryMulticenter studyTumor controlTumor volumeActuarial progression-free survival ratesNorth American Gamma Knife ConsortiumTumor progressionProgression-free survival ratesCox multivariate regression analysisTumor margin doseNew neurological deficitsCranial nerve deficitsPrimary treatment modalityKaplan-Meier analysisCranial nerves VLarger tumor volumeConventional radiation therapyMonths of imagingMultivariate regression analysisSignificance of histology in determining management of lesions regrowing after radiosurgery
Nath SK, Sheridan AD, Rauch PJ, Yu JB, Minja FJ, Vortmeyer AO, Chiang VL. Significance of histology in determining management of lesions regrowing after radiosurgery. Journal Of Neuro-Oncology 2014, 117: 303-310. PMID: 24504499, DOI: 10.1007/s11060-014-1389-2.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrain NeoplasmsFemaleHumansKaplan-Meier EstimateMaleMiddle AgedNeoplasm Recurrence, LocalRadiosurgeryConceptsBrain metastasesTumor cellsLocal controlSignificance of histologyWorse local controlResidual tumor cellsPost-treatment imagingManagement of lesionsOngoing patient managementInflammatory changesClinical outcomesResidual tumorSymptomatic enlargementAmbiguous etiologyHistologic findingsPatient outcomesPatient managementBrain specimensStereotactic radiosurgeryHistopathologic interpretationLesionsTissue specimensResectionPatientsMetastasis
2013
Efficacy and Safety of Higher Dose Stereotactic Radiosurgery for Functional Pituitary Adenomas: A Preliminary Report
Grant RA, Whicker M, Lleva R, Knisely JP, Inzucchi SE, Chiang VL. Efficacy and Safety of Higher Dose Stereotactic Radiosurgery for Functional Pituitary Adenomas: A Preliminary Report. World Neurosurgery 2013, 82: 195-201. PMID: 23385448, DOI: 10.1016/j.wneu.2013.01.127.Peer-Reviewed Original ResearchMeSH KeywordsAdenomaAdolescentAdultAgedDose-Response Relationship, RadiationFemaleFollow-Up StudiesHumansHypopituitarismKaplan-Meier EstimateMagnetic Resonance ImagingMaleMiddle AgedNeoplasm Recurrence, LocalOptic NervePituitary HormonesPituitary NeoplasmsPostoperative ComplicationsProspective StudiesRadiosurgeryRetrospective StudiesSurvival AnalysisTreatment OutcomeYoung AdultConceptsSingle-fraction stereotactic radiosurgeryPituitary adenomasEndocrine remissionMarginal dosesStereotactic radiosurgeryHigh-dose stereotactic radiosurgeryCommon adjuvant therapyHigher marginal doseNew endocrine deficienciesOptic nerve pallorPost-SRS hypopituitarismRadiation-induced hypopituitarismSecretory pituitary adenomasHigh-dose treatmentFunctional pituitary adenomasRadiation-induced sequelaeActive pituitary adenomasFraction stereotactic radiosurgeryHormonal normalizationHormonal remissionAdjuvant therapyCranial neuropathiesMarginal doseEndocrine deficienciesSurgical resection
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