title: Perilesional edema in brain metastasis from non-small cell lung cancer (NSCLC) as predictor of response to radiosurgery (SRS).
abstract: Radiosurgery (SRS) is widely used in the treatment of brain oligo-metastases from NSCLC. The aim of present study is to evaluate the extent of perilesional edema in brain metastases as predictive factor of treatment response. This single center retrospective study included 42 consecutive patients (January 2011-December 2014) with 1-2 brain metastasis from NSCLC treated with Radiosurgery (SRS). Extent of perilesional edema was measured as maximal extension from the edge of lesion and classified as minor (<10 mm) or major (≥10 mm). We analyzed Modality of Brain Recurrence (MBR), classified as in-field or out-of- field, and Brain Progression Free-Survival (BPFS) after treatment stratified according to extent of perilesional edema. Analyzing modality of brain recurrence and BPFS, after a median follow-up of 6 months, we found that patients with minor edema had a better radiological response to SRS with none in-field recurrences and a lower risk of the onset of new brain lesions (out-of-field recurrence). Instead, patients group with major edema had a worse response rate of lesions treated, further, a higher risk of out-of-field brain relapse. Extent of perilesional edema in brain metastasis from NSCLC could be a predictive factor of response and brain progression after SRS treatment alone.
authors.affiliation: IstitutoToscanoTumori, Florence, Italy. paolo-tini@libero.it.|Unit of Radiation Oncology, University Hospital of Siena, Policlinico S. Maria Alle Scotte, Viale Bracci, 53100, Siena, Italy. paolo-tini@libero.it.|Department of Medicine, Surgery and Neurological Sciences, Research Center for Molecular Radiobiology, University of Siena, Siena, Italy. paolo-tini@libero.it.
authors.forename: Paolo
authors.identifier: http://orcid.org/0000-0003-4826-4809
authors.initials: P
authors.lastname: Tini
authors.affiliation: IstitutoToscanoTumori, Florence, Italy.|Department of Medicine, Surgery and Neurological Sciences, Research Center for Molecular Radiobiology, University of Siena, Siena, Italy.
authors.forename: Valerio
authors.initials: V
authors.lastname: Nardone
authors.affiliation: IstitutoToscanoTumori, Florence, Italy.|Department of Medicine, Surgery and Neurological Sciences, Research Center for Molecular Radiobiology, University of Siena, Siena, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Pastina
authors.affiliation: IstitutoToscanoTumori, Florence, Italy.|Department of Medicine, Surgery and Neurological Sciences, Research Center for Molecular Radiobiology, University of Siena, Siena, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Battaglia
authors.affiliation: Unit of Clinical Neurology and Neurometabolic Disorders, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Vinciguerra
authors.affiliation: IstitutoToscanoTumori, Florence, Italy.|Unit of Radiation Oncology, University Hospital of Siena, Policlinico S. Maria Alle Scotte, Viale Bracci, 53100, Siena, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Carfagno
authors.affiliation: IstitutoToscanoTumori, Florence, Italy.|Unit of Radiation Oncology, University Hospital of Siena, Policlinico S. Maria Alle Scotte, Viale Bracci, 53100, Siena, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rubino
authors.affiliation: IstitutoToscanoTumori, Florence, Italy.|Unit of Diagnostic Radiology, University Hospital of Siena, Siena, Italy.
authors.forename: Salvatore Francesco
authors.initials: SF
authors.lastname: Carbone
authors.affiliation: IstitutoToscanoTumori, Florence, Italy.|Unit of Radiation Oncology, University Hospital of Siena, Policlinico S. Maria Alle Scotte, Viale Bracci, 53100, Siena, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Sebaste
authors.affiliation: Unit of Neuroradiology, University Hospital of Siena, Siena, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Cerase
authors.affiliation: Unit of Clinical Neurology and Neurometabolic Disorders, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Federico
authors.affiliation: IstitutoToscanoTumori, Florence, Italy.|Unit of Radiation Oncology, University Hospital of Siena, Policlinico S. Maria Alle Scotte, Viale Bracci, 53100, Siena, Italy.|Department of Medicine, Surgery and Neurological Sciences, Research Center for Molecular Radiobiology, University of Siena, Siena, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Pirtoli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging / Q000528:radiation effects / Q000601:surgery; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D001932:Brain Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy*; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology* / Q000628:therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D016634:Radiosurgery; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: Brain metastases; NSCLC; Peritumoral edema; Predictor; Stereotactic radiosurgery