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@ARTICLE{Rusthoven:275797,
author = {C. G. Rusthoven and A. W. Staley and D. Gao and S. Yomo and
D. Bernhardt and N. Wandrey and R. El Shafie and A. Kraemer
and O. Padilla and V. Chiang and A. M. Faramand and J. D.
Palmer and B. E. Zacharia and R. E. Wegner and J. A.
Hattangadi-Gluth and A. Levy and K. Bernstein and D. Mathieu
and D. N. Cagney and M. D. Chan and I. S. Grills and S.
Braunstein and C.-C. Lee and J. P. Sheehan and C. Kluwe and
S. Patel and L. M. Halasz and N. Andratschke and C. P.
Deibert and V. Verma and D. M. Trifiletti and C. P.
Cifarelli and J. Debus$^*$ and S. E. Combs and Y. Sato and
Y. Higuchi and K. Aoyagi and P. D. Brown and V. Alami and A.
Niranjan and L. D. Lunsford and D. Kondziolka and D. R.
Camidge and B. D. Kavanagh and T. P. Robin and T. Serizawa
and M. Yamamoto},
title = {{C}omparison of {F}irst-{L}ine {R}adiosurgery for
{S}mall-{C}ell and {N}on-{S}mall {C}ell {L}ung {C}ancer
{B}rain {M}etastases ({C}ross-{FIRE}).},
journal = {Journal of the National Cancer Institute},
volume = {115},
number = {8},
issn = {0027-8874},
address = {Oxford},
publisher = {Oxford Univ. Press},
reportid = {DKFZ-2023-00885},
pages = {926-936},
year = {2023},
note = {2023 Aug 8;115(8):926-936},
abstract = {Historical reservations regarding radiosurgery (SRS) for
small-cell-lung-cancer (SCLC) brain metastases (BrM) include
concerns for short-interval/diffuse CNS-progression, poor
prognoses, and increased neurological mortality specific to
SCLC histology. We compared SRS outcomes for SCLC and
non-small-cell-lung-cancer (NSCLC) where SRS is well
established.Multicenter first-line SRS outcomes for SCLC and
NSCLC from 2000-2022 were retrospectively collected
(N=892-SCLC/N=4,785-NSCLC). Data from the prospective
JLGK0901 SRS trial were analyzed as a comparison cohort
(N=98-SCLC/N=794-NSCLC). OS and CNS-progression were
analyzed using Cox-Proportional-Hazard and Fine-Gray models,
respectively, with multivariable (MV) adjustment (including
age/sex/performance-status/year/extracranial
disease/BrM-number/BrM-volume). Mutation-stratified analyses
were performed in propensity score-matched (PSM)
retrospective cohorts of EGFR/ALK-positive-NSCLC,
mutation-negative-NSCLC, and SCLC.OS was superior with NSCLC
over SCLC in the retrospective dataset (median-OS, 10.5 vs
8.6 months, MV-p<0.001) and JLGK0901. Hazard estimates for
first CNS-progression favoring NSCLC were similar in both
datasets but reached significance in the retrospective
dataset only (MV-HR:0.82 $[95\%-CI:0.73-0.92],$ p=0.001). In
the PSM cohorts, there were continued OS advantages for
NSCLC (median-OS, 23.7 [EGFR/ALK-positive-NSCLC] vs 13.6
[mutation-negative-NSCLC] vs 10.4 months [SCLC],
pairwise-p-values<0.001), but no significant differences in
CNS-progression. Neurological mortality and number of
lesions at CNS-progression were similar for NSCLC and SCLC
patients. Leptomeningeal-progression was increased in NSCLC
patients in the retrospective dataset only (MV-HR:1.61
$[95\%-CI:1.14-2.26],$ p=0.007).After SRS, SCLC was
associated with shorter OS compared to NSCLC. CNS
progression occurred earlier in SCLC overall but was similar
in patients matched on baseline characteristics.
Neurological mortality, lesions at CNS-progression, and
leptomeningeal-progression were comparable. These findings
may better inform clinical decision-making for SCLC
patients.},
keywords = {brain metastases (Other) / non-small cell lung cancer
(NSCLC) (Other) / small-cell lung cancer (SCLC) (Other) /
stereotactic radiosurgery (SRS) (Other) / whole brain
radiation therapy (WBRT) (Other)},
cin = {HD01},
ddc = {610},
cid = {I:(DE-He78)HD01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:37142267},
doi = {10.1093/jnci/djad073},
url = {https://inrepo02.dkfz.de/record/275797},
}