title: A comparison between cyberknife and neurosurgery in solitary brain metastases from non-small cell lung cancer.
abstract: OBJECTIVE
  To evaluate the efficacy of cyberknife (CK) and neurosurgery (NS) in patients newly diagnosed as solitary brain metastasis (SBM) from non-small cell lung cancer (NSCLC).
  
  
  METHODS
  We retrospectively analyzed 76 patients between 1990 and 2012 from our institution, including 38 patients performing CK and the other half performing NS. The observation end point was overall survival time (OS), local control of treated metastasis (LC) and intracranial control (IC). Kaplan-Meier OS curves were compared with the log-rank test. Cox regression analysis was used to determine prognosticators for OS, LC and IC.
  
  
  RESULTS
  The baseline characteristic between the two groups was not significantly different. The 1-year OS rates were 53.5% and 30.5% in the CK group and NS group, respectively, (p=0.121). The 1-year LC rates were 50.8% and 31.3%, respectively, (p=0.078). The 1-year IC rates were 50.8% and 27.7%, respectively, (p=0.066). In multivariate analysis, improved OS was significantly associated with younger age (p=0.016), better ECOG performance status (p=0.000) and graded prognostic assessment (GPA, 3.5-4.0, p=0.006). The LC was also associated with better ECOG performance status (p=0.000). The IC was associated with both better ECOG performance status (p=0.000) and GPA (3.5-4.0, p=0.005).
  
  
  CONCLUSIONS
  There was no statistical difference between CK and NS for SBM from NSCLC in OS, LC and IC. However, CK is less invasive and may be more acceptable for patients. The result needs randomized trials to confirm and further study.
authors.affiliation: Department of Radiation Oncology, Tianjin Medical University Cancer Hospital & Institute, Tianjin 300060 PR China.
authors.forename: Li-Jun
authors.initials: LJ
authors.lastname: Tian
authors.forename: Hong-Qing
authors.initials: HQ
authors.lastname: Zhuang
authors.forename: Zhi-Yong
authors.initials: ZY
authors.lastname: Yuan
mesh_terms: D000367:Age Factors; D000368:Aged; D001932:Brain Neoplasms / Q000556:secondary* / Q000601:surgery*; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D023381:Endpoint Determination; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D011379:Prognosis; D016634:Radiosurgery / Q000379:methods*; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Cyberknife; NSCLC; Neurosurgery; Solitary brain metastasis