Local control and survival after stereotactic radiosurgery for colorectal cancer brain metastases: an international multicenter analysis

Othman Bin-Alamer; Hussam Abou-Al-Shaar; Raj Singh; Arka N. Mallela; Andrew Legarreta; Greg Bowden; David Mathieu; Haley K. Perlow; Joshua D. Palmer; Shahed Elhamdani; Matthew Shepard; Yun Liang; Ahmed M. Nabeel; Wael A. Reda; Sameh R. Tawadros; Khaled Abdelkarim; Amr M.N. El-Shehaby; Reem Emad Eldin; Ahmed Hesham Elazzazi; Ronald E. Warnick; Yair M. Gozal; Megan Daly; Brendan McShane; Marcel Addis-Jackson; Gokul Karthikeyan; Sian Smith; Piero Picozzi; Andrea Franzini; Tehila Kaisman-Elbaz; Huai Che Yang; Judith Hess; Kelsey Templeton; Xiaoran Zhang; Zhishuo Wei; Stylianos Pikis; Georgios Mantziaris; Gabriela Simonova; Roman Liscak; Selcuk Peker; Yavuz Samanci; Veronica Chiang; Charles R. Kersh; Cheng Chia Lee; Daniel M. Trifiletti; Ajay Niranjan; Constantinos G. Hadjipanayis; L. Dade Lunsford; Jason P. Sheehan

doi:10.3171/2023.8.JNS231231

Local control and survival after stereotactic radiosurgery for colorectal cancer brain metastases: an international multicenter analysis

Othman Bin-Alamer, Hussam Abou-Al-Shaar, Raj Singh, Arka N. Mallela, Andrew Legarreta, Greg Bowden, David Mathieu, Haley K. Perlow, Joshua D. Palmer, Shahed Elhamdani, Matthew Shepard, Yun Liang, Ahmed M. Nabeel, Wael A. Reda, Sameh R. Tawadros, Khaled Abdelkarim, Amr M.N. El-Shehaby, Reem Emad Eldin, Ahmed Hesham Elazzazi, Ronald E. WarnickYair M. Gozal, Megan Daly, Brendan McShane, Marcel Addis-Jackson, Gokul Karthikeyan, Sian Smith, Piero Picozzi, Andrea Franzini, Tehila Kaisman-Elbaz, Huai Che Yang, Judith Hess, Kelsey Templeton, Xiaoran Zhang, Zhishuo Wei, Stylianos Pikis, Georgios Mantziaris, Gabriela Simonova, Roman Liscak, Selcuk Peker, Yavuz Samanci, Veronica Chiang, Charles R. Kersh, Cheng Chia Lee, Daniel M. Trifiletti, Ajay Niranjan, Constantinos G. Hadjipanayis, L. Dade Lunsford, Jason P. Sheehan

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

OBJECTIVE The goal of this study was to characterize local tumor control (LC), overall survival (OS), and safety of stereotactic radiosurgery for colorectal brain metastasis (CRBM). METHODS Ten international institutions participating in the International Radiosurgery Research Foundation provided data for this retrospective case series. This study included 187 patients with CRBM (281 tumors), with a median age of 62 years and 56.7% being male. Most patients (53.5%) had solitary tumors, although 10.7% had > 5 tumors. The median tumor volume was 2.7 cm³ (IQR 0.22–8.1 cm³), and the median margin dose was 20 Gy (IQR 18–22 Gy). RESULTS The 3-year LC and OS rates were 72% and 20%, respectively. Symptomatic adverse radiation effects occurred in 1.6% of patients. In the multivariate analysis, age > 65 years and tumor volume > 4.0 cm³ were significant predictors of tumor progression (hazard ratio [HR] 2.6, 95% CI 1.4–4.9; p = 0.003 and HR 3.4, 95% CI 1.7–6.9; p < 0.001, respectively). Better performance status (Karnofsky Performance Scale score > 80) was associated with a reduced risk of tumor progression (HR 0.38, 95% CI 0.19–0.73; p = 0.004). Patient age > 62 years (HR 1.6, 95% CI 1.1–2.3; p = 0.03) and the presence of active extracranial disease (HR 1.7, 95% CI 1.1–2.4; p = 0.009) were significantly associated with worse OS. CONCLUSIONS Stereotactic radiosurgery offers a high LC rate and a low rate of symptomatic adverse radiation effects for the majority of CRBMs. The OS and LC favored younger patients with high functional performance scores and inactive extracranial disease. https://thejns.org/doi/abs/10.3171/2023.8.JNS231231

Original language	English
Pages (from-to)	1233-1242
Number of pages	10
Journal	Journal of Neurosurgery
Volume	140
Issue number	5
DOIs	https://doi.org/10.3171/2023.8.JNS231231
State	Published - 1 May 2024
Externally published	Yes

Keywords

Gamma Knife radiosurgery
brain metastasis
colorectal cancer
local tumor control
oncology
overall survival
stereotactic radiosurgery
tumor

ASJC Scopus subject areas

Surgery
Clinical Neurology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3171/2023.8.JNS231231

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Bin-Alamer, O., Abou-Al-Shaar, H., Singh, R., Mallela, A. N., Legarreta, A., Bowden, G., Mathieu, D., Perlow, H. K., Palmer, J. D., Elhamdani, S., Shepard, M., Liang, Y., Nabeel, A. M., Reda, W. A., Tawadros, S. R., Abdelkarim, K., El-Shehaby, A. M. N., Eldin, R. E., Elazzazi, A. H., ... Sheehan, J. P. (2024). Local control and survival after stereotactic radiosurgery for colorectal cancer brain metastases: an international multicenter analysis. Journal of Neurosurgery, 140(5), 1233-1242. https://doi.org/10.3171/2023.8.JNS231231

@article{0320e8354fa14c749aedf5ab27b095eb,

title = "Local control and survival after stereotactic radiosurgery for colorectal cancer brain metastases: an international multicenter analysis",

abstract = "OBJECTIVE The goal of this study was to characterize local tumor control (LC), overall survival (OS), and safety of stereotactic radiosurgery for colorectal brain metastasis (CRBM). METHODS Ten international institutions participating in the International Radiosurgery Research Foundation provided data for this retrospective case series. This study included 187 patients with CRBM (281 tumors), with a median age of 62 years and 56.7% being male. Most patients (53.5%) had solitary tumors, although 10.7% had > 5 tumors. The median tumor volume was 2.7 cm3 (IQR 0.22–8.1 cm3), and the median margin dose was 20 Gy (IQR 18–22 Gy). RESULTS The 3-year LC and OS rates were 72% and 20%, respectively. Symptomatic adverse radiation effects occurred in 1.6% of patients. In the multivariate analysis, age > 65 years and tumor volume > 4.0 cm3 were significant predictors of tumor progression (hazard ratio [HR] 2.6, 95% CI 1.4–4.9; p = 0.003 and HR 3.4, 95% CI 1.7–6.9; p < 0.001, respectively). Better performance status (Karnofsky Performance Scale score > 80) was associated with a reduced risk of tumor progression (HR 0.38, 95% CI 0.19–0.73; p = 0.004). Patient age > 62 years (HR 1.6, 95% CI 1.1–2.3; p = 0.03) and the presence of active extracranial disease (HR 1.7, 95% CI 1.1–2.4; p = 0.009) were significantly associated with worse OS. CONCLUSIONS Stereotactic radiosurgery offers a high LC rate and a low rate of symptomatic adverse radiation effects for the majority of CRBMs. The OS and LC favored younger patients with high functional performance scores and inactive extracranial disease. https://thejns.org/doi/abs/10.3171/2023.8.JNS231231",

keywords = "Gamma Knife radiosurgery, brain metastasis, colorectal cancer, local tumor control, oncology, overall survival, stereotactic radiosurgery, tumor",

author = "Othman Bin-Alamer and Hussam Abou-Al-Shaar and Raj Singh and Mallela, {Arka N.} and Andrew Legarreta and Greg Bowden and David Mathieu and Perlow, {Haley K.} and Palmer, {Joshua D.} and Shahed Elhamdani and Matthew Shepard and Yun Liang and Nabeel, {Ahmed M.} and Reda, {Wael A.} and Tawadros, {Sameh R.} and Khaled Abdelkarim and El-Shehaby, {Amr M.N.} and Eldin, {Reem Emad} and Elazzazi, {Ahmed Hesham} and Warnick, {Ronald E.} and Gozal, {Yair M.} and Megan Daly and Brendan McShane and Marcel Addis-Jackson and Gokul Karthikeyan and Sian Smith and Piero Picozzi and Andrea Franzini and Tehila Kaisman-Elbaz and Yang, {Huai Che} and Judith Hess and Kelsey Templeton and Xiaoran Zhang and Zhishuo Wei and Stylianos Pikis and Georgios Mantziaris and Gabriela Simonova and Roman Liscak and Selcuk Peker and Yavuz Samanci and Veronica Chiang and Kersh, {Charles R.} and Lee, {Cheng Chia} and Trifiletti, {Daniel M.} and Ajay Niranjan and Hadjipanayis, {Constantinos G.} and {Dade Lunsford}, L. and Sheehan, {Jason P.}",

note = "Publisher Copyright: {\textcopyright}AANS 2024, except where prohibited by US copyright law.",

year = "2024",

month = may,

day = "1",

doi = "10.3171/2023.8.JNS231231",

language = "English",

volume = "140",

pages = "1233--1242",

journal = "Journal of Neurosurgery",

issn = "0022-3085",

publisher = "American Association of Neurological Surgeons",

number = "5",

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Bin-Alamer, O, Abou-Al-Shaar, H, Singh, R, Mallela, AN, Legarreta, A, Bowden, G, Mathieu, D, Perlow, HK, Palmer, JD, Elhamdani, S, Shepard, M, Liang, Y, Nabeel, AM, Reda, WA, Tawadros, SR, Abdelkarim, K, El-Shehaby, AMN, Eldin, RE, Elazzazi, AH, Warnick, RE, Gozal, YM, Daly, M, McShane, B, Addis-Jackson, M, Karthikeyan, G, Smith, S, Picozzi, P, Franzini, A, Kaisman-Elbaz, T, Yang, HC, Hess, J, Templeton, K, Zhang, X, Wei, Z, Pikis, S, Mantziaris, G, Simonova, G, Liscak, R, Peker, S, Samanci, Y, Chiang, V, Kersh, CR, Lee, CC, Trifiletti, DM, Niranjan, A, Hadjipanayis, CG, Dade Lunsford, L & Sheehan, JP 2024, 'Local control and survival after stereotactic radiosurgery for colorectal cancer brain metastases: an international multicenter analysis', Journal of Neurosurgery, vol. 140, no. 5, pp. 1233-1242. https://doi.org/10.3171/2023.8.JNS231231

TY - JOUR

T1 - Local control and survival after stereotactic radiosurgery for colorectal cancer brain metastases

T2 - an international multicenter analysis

AU - Bin-Alamer, Othman

AU - Abou-Al-Shaar, Hussam

AU - Singh, Raj

AU - Mallela, Arka N.

AU - Legarreta, Andrew

AU - Bowden, Greg

AU - Mathieu, David

AU - Perlow, Haley K.

AU - Palmer, Joshua D.

AU - Elhamdani, Shahed

AU - Shepard, Matthew

AU - Liang, Yun

AU - Nabeel, Ahmed M.

AU - Reda, Wael A.

AU - Tawadros, Sameh R.

AU - Abdelkarim, Khaled

AU - El-Shehaby, Amr M.N.

AU - Eldin, Reem Emad

AU - Elazzazi, Ahmed Hesham

AU - Warnick, Ronald E.

AU - Gozal, Yair M.

AU - Daly, Megan

AU - McShane, Brendan

AU - Addis-Jackson, Marcel

AU - Karthikeyan, Gokul

AU - Smith, Sian

AU - Picozzi, Piero

AU - Franzini, Andrea

AU - Kaisman-Elbaz, Tehila

AU - Yang, Huai Che

AU - Hess, Judith

AU - Templeton, Kelsey

AU - Zhang, Xiaoran

AU - Wei, Zhishuo

AU - Pikis, Stylianos

AU - Mantziaris, Georgios

AU - Simonova, Gabriela

AU - Liscak, Roman

AU - Peker, Selcuk

AU - Samanci, Yavuz

AU - Chiang, Veronica

AU - Kersh, Charles R.

AU - Lee, Cheng Chia

AU - Trifiletti, Daniel M.

AU - Niranjan, Ajay

AU - Hadjipanayis, Constantinos G.

AU - Dade Lunsford, L.

AU - Sheehan, Jason P.

PY - 2024/5/1

Y1 - 2024/5/1

N2 - OBJECTIVE The goal of this study was to characterize local tumor control (LC), overall survival (OS), and safety of stereotactic radiosurgery for colorectal brain metastasis (CRBM). METHODS Ten international institutions participating in the International Radiosurgery Research Foundation provided data for this retrospective case series. This study included 187 patients with CRBM (281 tumors), with a median age of 62 years and 56.7% being male. Most patients (53.5%) had solitary tumors, although 10.7% had > 5 tumors. The median tumor volume was 2.7 cm3 (IQR 0.22–8.1 cm3), and the median margin dose was 20 Gy (IQR 18–22 Gy). RESULTS The 3-year LC and OS rates were 72% and 20%, respectively. Symptomatic adverse radiation effects occurred in 1.6% of patients. In the multivariate analysis, age > 65 years and tumor volume > 4.0 cm3 were significant predictors of tumor progression (hazard ratio [HR] 2.6, 95% CI 1.4–4.9; p = 0.003 and HR 3.4, 95% CI 1.7–6.9; p < 0.001, respectively). Better performance status (Karnofsky Performance Scale score > 80) was associated with a reduced risk of tumor progression (HR 0.38, 95% CI 0.19–0.73; p = 0.004). Patient age > 62 years (HR 1.6, 95% CI 1.1–2.3; p = 0.03) and the presence of active extracranial disease (HR 1.7, 95% CI 1.1–2.4; p = 0.009) were significantly associated with worse OS. CONCLUSIONS Stereotactic radiosurgery offers a high LC rate and a low rate of symptomatic adverse radiation effects for the majority of CRBMs. The OS and LC favored younger patients with high functional performance scores and inactive extracranial disease. https://thejns.org/doi/abs/10.3171/2023.8.JNS231231

AB - OBJECTIVE The goal of this study was to characterize local tumor control (LC), overall survival (OS), and safety of stereotactic radiosurgery for colorectal brain metastasis (CRBM). METHODS Ten international institutions participating in the International Radiosurgery Research Foundation provided data for this retrospective case series. This study included 187 patients with CRBM (281 tumors), with a median age of 62 years and 56.7% being male. Most patients (53.5%) had solitary tumors, although 10.7% had > 5 tumors. The median tumor volume was 2.7 cm3 (IQR 0.22–8.1 cm3), and the median margin dose was 20 Gy (IQR 18–22 Gy). RESULTS The 3-year LC and OS rates were 72% and 20%, respectively. Symptomatic adverse radiation effects occurred in 1.6% of patients. In the multivariate analysis, age > 65 years and tumor volume > 4.0 cm3 were significant predictors of tumor progression (hazard ratio [HR] 2.6, 95% CI 1.4–4.9; p = 0.003 and HR 3.4, 95% CI 1.7–6.9; p < 0.001, respectively). Better performance status (Karnofsky Performance Scale score > 80) was associated with a reduced risk of tumor progression (HR 0.38, 95% CI 0.19–0.73; p = 0.004). Patient age > 62 years (HR 1.6, 95% CI 1.1–2.3; p = 0.03) and the presence of active extracranial disease (HR 1.7, 95% CI 1.1–2.4; p = 0.009) were significantly associated with worse OS. CONCLUSIONS Stereotactic radiosurgery offers a high LC rate and a low rate of symptomatic adverse radiation effects for the majority of CRBMs. The OS and LC favored younger patients with high functional performance scores and inactive extracranial disease. https://thejns.org/doi/abs/10.3171/2023.8.JNS231231

KW - Gamma Knife radiosurgery

KW - brain metastasis

KW - colorectal cancer

KW - local tumor control

KW - oncology

KW - overall survival

KW - stereotactic radiosurgery

KW - tumor

UR - http://www.scopus.com/inward/record.url?scp=85192112804&partnerID=8YFLogxK

U2 - 10.3171/2023.8.JNS231231

DO - 10.3171/2023.8.JNS231231

M3 - Article

C2 - 37948682

AN - SCOPUS:85192112804

SN - 0022-3085

VL - 140

SP - 1233

EP - 1242

JO - Journal of Neurosurgery

JF - Journal of Neurosurgery

IS - 5

ER -

Local control and survival after stereotactic radiosurgery for colorectal cancer brain metastases: an international multicenter analysis

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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