title: Pro-inflammatory State Portends Poor Outcomes with Stereotactic Radiosurgery for Brain Metastases.
abstract: We determined if pre-treatment systemic inflammation would predict poor outcomes in the setting of stereotactic radiosurgery (SRS) for brain metastases.
  
  
  
  The pretreatment albumin concentration, neutrophil and lymphocyte counts, and the platelet-to-lymphocyte ratio (PLR) were evaluated to determine association with intracranial control, local control (LC), initial MRI response (MR), and overall survival (OS) among 70 patients with 152 separate brain metastases treated with SRS alone from 2008-2015.
  
  
  
  On multivariate analysis, a higher neutrophil percentage predicted for poor LC, poor initial MR, poor OS and poor intracranial control (p=0.01, p=0.01, p=0.02 and p=0.03, respectively). A lower percentage of lymphocytes predicted for poor LC and poor MR (p=0.01 and p=0.02), and an elevated PLR predicted for poor OS and poor LC (p=0.05 and p=0.04). Additionally, a lower pretreatment albumin concentration predicted for poor LC and OS (p=0.01 and p=0.03).
  
  
  
  Pretreatment systemic inflammation is associated with poor outcomes post-SRS.
authors: Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, U.S.A.
authors: Narek
authors: N
authors: Shaverdian
authors: Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, U.S.A.
authors: Jason
authors: J
authors: Wang
authors: Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, U.S.A.
authors: Rebecca
authors: R
authors: Levin-Epstein
authors: Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, U.S.A.
authors: Dorthe
authors: D
authors: Schaue
authors: Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, U.S.A.
authors: Patrick
authors: P
authors: Kupelian
authors: Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, U.S.A.
authors: Percy
authors: P
authors: Lee
authors: Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, U.S.A.
authors: Isaac
authors: I
authors: Yang
authors: Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, U.S.A. TKaprealian@mednet.ucla.edu.
authors: Tania
authors: T
authors: Kaprealian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000097:blood / Q000276:immunology / Q000532:radiotherapy / Q000556:secondary; D001943:Breast Neoplasms / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007958:Leukocyte Count; D008214:Lymphocytes / Q000166:cytology; D008297:Male; D008545:Melanoma / Q000473:pathology; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology; D010976:Platelet Count; D011379:Prognosis; D016634:Radiosurgery / Q000009:adverse effects; D012709:Serum Albumin / Q000032:analysis; D016896:Treatment Outcome
chemical_list: D012709:Serum Albumin
keywords: Brain metastases; SRS; immune responses; inflammation; radiosurgery