title: Evaluation of results of linac-based radiosurgery for brain metastases from primary lung cancer.
abstract: OBJECTIVE
  The purpose of our review was to evaluate results of radiosurgery for patients with brain metastases from lung cancer.
  
  
  BACKGROUND
  Lung cancer is the leading cause of death from cancer and the most common source of brain metastases. Radiosurgery allows the precise focal delivery of a high single radiation dose to brain metastases and results in high rates of local control.
  
  
  METHODS
  83 patients were treated between 2006 and 2008. We evaluated local control and outcome after radiosurgery and identified prognostic factors.
  
  
  RESULTS
  Median survival in the whole group was 7.8 months from radiosurgery and 11 months from diagnosis. Median survival in classes I, II and III was 13.2, 8.2 and 2.2 months. For 94% of patients symptoms improved or stabilised at the first follow-up visit and this status did not change during 7.1 months. According to the univariate analysis, factors associated with improved survival included: RPA class 1 compared with RPA 2 and 3, RPA class 2 compared with RPA 3, KPS > 70, control of the primary disease, radiosurgery performed more than once, level of haemoglobin >7 mmol/1, absence of extracranial metastases, volume of the biggest lesion <11 cm(3). The multivariate analysis confirmed a significant influence on survival for the following factors: RPA class 1 as compared with RPA 3, KPS > 70, absence of extracranial metastases, multiplicity of radiosurgery.
  
  
  CONCLUSIONS
  Stereotactic radiosurgery is a safe and effective treatment. It proved to be effective and safe in older patients. Selection of patients who are likely to benefit most should be based on prognostic factors. KPS proved to be the most important prognostic factor. In the RPA III group (patients with KPS < 70) survival time was similar to that achieved after symptomatic medical management.
authors.affiliation: Greater Poland Cancer Centre, Garbary 15 Str., 61-866 Poznań, Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Jezierska
authors.affiliation: Greater Poland Cancer Centre, Garbary 15 Str., 61-866 Poznań, Poland.
authors.forename: Krystyna
authors.initials: K
authors.lastname: Adamska
authors.affiliation: Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Włodzimierz
authors.initials: W
authors.lastname: Liebert
keywords: Brain metastasis; Lung cancer; Prognostic factors; Radiosurgery