title: Outcomes of Gamma Knife Radiosurgery in Combination with Crizotinib for Patients with Brain Metastasis from Non-Small Cell Lung Cancer.
abstract: OBJECTIVE
  Crizotinib is a novel targeted anticancer agent for non-small cell lung cancer. In this study, we report our clinical outcomes from Gamma Knife radiosurgery (GKS) for brain metastasis (BM) under crizotinib treatment in non-small cell lung cancer patients.
  
  
  METHODS
  We performed a retrospective review of 29 patients who underwent a total of 51 GKS procedures for BM while continuing on crizotinib. We compared 2 groups on the basis of the number of BMs: oligometastases (≤5) and polymetastases (>5).
  
  
  RESULTS
  The actuarial 1- and 2-year overall survival rates from initial GKS were 73.5% and 42.6%, respectively. The estimated local progression-free survival (PFS) rates of the oligometastases group were 91.8% at 6 months and 84.2% at 12 months, whereas the local PFS rates of the polymetastases group at 6 and 12 months were 91.6% and 58.2%, respectively (P = 0.153). The estimated distant PFS rates of the oligometastases group were 50.7% at 6 months and 20.3% at 12 months, whereas the distant PFS rates of the polymetastases group were 32.7% at 6 months and only 6.5% at 12 months (P = 0.029).
  
  
  CONCLUSIONS
  GKS combined with crizotinib showed effective local tumor control and excellent outcome, especially in oligometastases. However, distant progression of BM during crizotinib after GKS occurred in most of the cases within a year. Thus brain surveillance after GKS is important for adequate and timely salvage treatment even when extracranial disease is well controlled by crizotinib.
authors: Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea.
authors: Jung Won
authors: JW
authors: Choi
authors: Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea.
authors: Doo-Sik
authors: DS
authors: Kong
authors: Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea.
authors: Ho Jun
authors: HJ
authors: Seol
authors: Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea.
authors: Do-Hyun
authors: DH
authors: Nam
authors: Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea.
authors: Kwai Han
authors: KH
authors: Yoo
authors: Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea.
authors: Jong-Mu
authors: JM
authors: Sun
authors: Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea.
authors: Jin-Seok
authors: JS
authors: Ahn
authors: Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea.
authors: Myung-Ju
authors: MJ
authors: Ahn
authors: Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea.
authors: Keunchil
authors: K
authors: Park
authors: Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea. Electronic address: jilee@skku.edu.
authors: Jung-Il
authors: JI
authors: Lee
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary / Q000628:therapy*; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000556:secondary / Q000628:therapy*; D002289:Carcinoma, Non-Small-Cell Lung / Q000556:secondary / Q000628:therapy; D000077547:Crizotinib; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011720:Pyrazoles / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use*; D016634:Radiosurgery; D012189:Retrospective Studies
chemical_list: D047428:Protein Kinase Inhibitors; D011720:Pyrazoles; D011725:Pyridines; D000077547:Crizotinib
keywords: Brain metastasis; Crizotinib; Gamma Knife; Lung cancer; Radiosurgery