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  • [Sci Rep.] A 3-month survival model after Gamma Knife surgery in patients with brain metastasis from lung cancer with Karnofsky performance status ≤ 70전신수행도가 낮은 폐암 뇌전이 환자에서 감마 나이프수술 후 생존 모델 개발

    서울대병원 / 박한글, 이은정*

  • 출처
    Sci Rep.
  • 등재일
    2023 Aug 12
  • 저널이슈번호
    13(1):13159. doi: 10.1038/s41598-023-40356-6.
  • 내용

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    Abstract
    Gamma Knife surgery (GKS) for brain metastasis (BM) has been generally advocated for patients with a Karnofsky performance status (KPS) scale of ≥ 70. However, some patients with a poor KPS scale of < 70 are recoverable after GKS and show durable survival. A purpose of this study is to devise a 3-month survival prediction model to screen patients with BM with a KPS of ≤ 70 in whom GKS is needed. A retrospective analysis of 67 patients with a KPS scale of 60-70 undergoing GKS for BM of non-small cell lung cancer (NSCLC) from 2016 to 2020 in our institute was performed. Univariate and multivariate logistic regression analyses were performed to investigate factors related to survival for more than 3 months after GKS. The probability (P) prediction model was designed by giving a weight corresponding to the odds ratio of the variables. The overall survival was 9.9 ± 12.7 months (range 0.2-53.2), with a 3-month survival rate of 59.7% (n = 40). In multivariate logistic regression analysis, extracranial disease (ECD) control (p = .033), focal neurological deficit (FND) (p = .014), and cumulative tumor volume (∑ TV) (p = .005) were associated with 3-month survival. The prediction model of 3-month survival (Harrell's C index = 0.767) was devised based on associated factors. In conclusion, GKS for BMs is recommended in selected patients, even if the KPS scale is ≤ 70.

     

     

    Affiliations

    Hangeul Park 1, Hyun-Tai Chung 1 2 3, Jin-Wook Kim 1 2 3, Yun-Sik Dho 4, Eun Jung Lee 5 6 7
    1Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea.
    2Gamma Knife Radiosurgery Center, Seoul National University Hospital, Seoul, Republic of Korea.
    3Seoul National University College of Medicine, Seoul, Republic of Korea.
    4Neuro-Oncology Clinic, National Cancer Center, Goyang, Republic of Korea.
    5Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea. eunjlee21@snu.ac.kr.
    6Gamma Knife Radiosurgery Center, Seoul National University Hospital, Seoul, Republic of Korea. eunjlee21@snu.ac.kr.
    7Seoul National University College of Medicine, Seoul, Republic of Korea. eunjlee21@snu.ac.kr.

  • 편집위원

    폐암의 뇌전이 환자에서 과거 전신수행도(KPS)가 70 이상인 환자에서 감마나이프 같은 방사선수술이 추천되었지만, 해당 연구에서는 전신수행도가 다소 떨어지는 (KPS of 60-70) 환자들 중 3개월 생존 가능성을 계산하는 모델을 고안하여 일부 환자에게도 감마나이프 치료를 고려해볼 수 있을 것으로 제안하였다.

    2023-10-06 16:14:47

  • 편집위원2

    전신수행능력이 낮은 환자에서 감마나이프 수술의 결과를 분석한 연구로, extracranial disease, focal neurological deficit, tumor volume 이 3개월 생존율과 연관이 있고, 이를 기반으로 예측 모델을 만듦. 이를 통해 전신 수행능력이 낮은 경우 뇌 방사선수술이 잘 시행되지않지만, 특정 환자들에서 효용성이 있을 것임을 생각해볼 수 있음.

    2023-10-06 16:15:43

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