2021
Adverse radiation effects in volume-staged radiosurgery for large arteriovenous malformations: a multiinstitutional study.
Seymour ZA, Chan JW, McDermott MW, Grills I, Ye H, Kano H, Lehocky CA, Jacobs RC, Lunsford LD, Chytka T, Liščák R, Lee CC, Yang HC, Ding D, Sheehan JP, Feliciano CE, Rodriguez-Mercado R, Chiang VL, Hess JA, Sommaruga S, McShane B, Lee JYK, Vasas LT, Kaufmann AM, Sneed PK. Adverse radiation effects in volume-staged radiosurgery for large arteriovenous malformations: a multiinstitutional study. Journal Of Neurosurgery 2021, 136: 503-511. PMID: 34450589, DOI: 10.3171/2020.12.jns201866.Peer-Reviewed Original ResearchMeSH KeywordsAdultFollow-Up StudiesHumansIntracranial Arteriovenous MalformationsProspective StudiesRadiosurgeryRetrospective StudiesTreatment OutcomeConceptsAdverse radiation effectsLarge arteriovenous malformationsArteriovenous malformationsVS-SRSLobe involvementSymptomatic adverse radiation effectsVolume-staged stereotactic radiosurgeryMedian margin doseOptimal treatment paradigmAVM nidus volumeTemporal lobe involvementVolume-staged radiosurgeryParietal lobe involvementMultiinstitutional cohortRadiosurgical centersMargin doseMedian ageRetrospective reviewEntire nidusMaximal linear dimensionMultiinstitutional studyNidus volumeTreatment paradigmStereotactic radiosurgeryPatientsComparison of radiomic feature aggregation methods for patients with multiple tumors
Chang E, Joel MZ, Chang HY, Du J, Khanna O, Omuro A, Chiang V, Aneja S. Comparison of radiomic feature aggregation methods for patients with multiple tumors. Scientific Reports 2021, 11: 9758. PMID: 33963236, PMCID: PMC8105371, DOI: 10.1038/s41598-021-89114-6.Peer-Reviewed Original ResearchConceptsCox proportional hazards modelCox proportional hazardsProportional hazards modelBrain metastasesRadiomic featuresHazards modelProportional hazardsStandard Cox proportional hazards modelMultifocal brain metastasesMultiple brain metastasesNumber of patientsPatient-level outcomesHigher concordance indexRadiomic feature analysisRandom survival forest modelSurvival modelsDifferent tumor volumesMultifocal tumorsCancer outcomesMultiple tumorsMetastatic cancerConcordance indexTumor volumePatientsTumor types
2020
Laser interstitial thermal therapy (LITT) vs. bevacizumab for radiation necrosis in previously irradiated brain metastases
Sujijantarat N, Hong CS, Owusu KA, Elsamadicy AA, Antonios JP, Koo AB, Baehring JM, Chiang VL. Laser interstitial thermal therapy (LITT) vs. bevacizumab for radiation necrosis in previously irradiated brain metastases. Journal Of Neuro-Oncology 2020, 148: 641-649. PMID: 32602021, DOI: 10.1007/s11060-020-03570-0.Peer-Reviewed Original ResearchConceptsLaser interstitial thermal therapyLonger overall survivalRadiation necrosisInterstitial thermal therapyBrain metastasesOverall survivalMedian volume decreaseMedian volume increaseBrain metastasis patientsPre-treatment patient characteristicsRetrospective chart reviewResultsTwenty-five patientsPre-treatment factorsBevacizumab patientsChart reviewMetastasis patientsLocal recurrencePatient characteristicsTreatment optionsTreatment responseBevacizumabPatientsLesional volumeThermal therapyStatistical significance
2019
Dose response and architecture in volume staged radiosurgery for large arteriovenous malformations: A multi-institutional study
Seymour ZA, Chan JW, Sneed PK, Kano H, Lehocky CA, Jacobs RC, Ye H, Chytka T, Liscak R, Lee CC, Yang HC, Ding D, Sheehan J, Feliciano CE, Rodriguez-Mercado R, Chiang VL, Hess JA, Sommaruga S, McShane B, Lee J, Vasas LT, Kaufmann AM, Grills I, McDermott MW. Dose response and architecture in volume staged radiosurgery for large arteriovenous malformations: A multi-institutional study. Radiotherapy And Oncology 2019, 144: 180-188. PMID: 31835173, DOI: 10.1016/j.radonc.2019.09.019.Peer-Reviewed Original ResearchMeSH KeywordsAdultFollow-Up StudiesHumansIntracranial Arteriovenous MalformationsProspective StudiesRadiosurgeryRetrospective StudiesTreatment OutcomeConceptsLarge arteriovenous malformationsArteriovenous malformationsVS-SRSMargin doseObliteration rateVolume-staged stereotactic radiosurgeryMedian margin doseHigh-risk lesionsOptimal treatment paradigmAVM nidus volumeMulti-institutional studyImproved ratesCompact nidusEvaluable patientsMedian followRadiosurgical centersOverall survivalUpfront treatmentComplete responseMedian ageRetrospective reviewCure rateRare lesionsPrior embolizationTreatment paradigmLocal tumor response and survival outcomes after combined stereotactic radiosurgery and immunotherapy in non-small cell lung cancer with brain metastases.
Singh C, Qian JM, Yu JB, Chiang VL. Local tumor response and survival outcomes after combined stereotactic radiosurgery and immunotherapy in non-small cell lung cancer with brain metastases. Journal Of Neurosurgery 2019, 132: 512-517. PMID: 30771783, DOI: 10.3171/2018.10.jns181371.Peer-Reviewed Original ResearchConceptsAnti-PD-1 therapyKarnofsky performance statusBrain metastasesLung cancer patientsStereotactic radiosurgeryCT groupIT groupCancer patientsNon-small cell lung cancer patientsNon-small cell lung cancerCell lung cancer patientsAntibody-positive patientsGraded Prognostic AssessmentCox regression analysisCell lung cancerMedian survival timeLocal tumor responseWhole study groupMann-Whitney U testTerms of survivalLesional responseMedian survivalPerformance statusWorse survivalComplete response
2018
Quality of life outcomes for brain metastasis patients treated with stereotactic radiosurgery: pre-procedural predictive factors from a prospective national registry.
Sheehan JP, Grills I, Chiang VL, Dong H, Berg A, Warnick RE, Kondziolka D, Kavanagh B. Quality of life outcomes for brain metastasis patients treated with stereotactic radiosurgery: pre-procedural predictive factors from a prospective national registry. Journal Of Neurosurgery 2018, 131: 1848-1854. PMID: 30579284, DOI: 10.3171/2018.8.jns181599.Peer-Reviewed Original ResearchConceptsQuality of lifeBrain metastasis patientsBrain metastasesStereotactic radiosurgeryMetastasis patientsEarly stereotactic radiosurgeryPre-procedural factorsProspective national registryPain/discomfortKarnofsky Performance Scale statusAnxiety/depressionMultivariate linear regression modelRadiological responseInitial presentationPatients' qualityMale sexPredictive factorsNational registryTreatment attributesMedical treatmentPatientsMetastasisSubscoresLife outcomesLife factorsEstimating survival for renal cell carcinoma patients with brain metastases: an update of the Renal Graded Prognostic Assessment tool
Sperduto PW, Deegan BJ, Li J, Jethwa KR, Brown PD, Lockney N, Beal K, Rana NG, Attia A, Tseng CL, Sahgal A, Shanley R, Sperduto WA, Lou E, Zahra A, Buatti JM, Yu JB, Chiang V, Molitoris JK, Masucci L, Roberge D, Shi DD, Shih HA, Olson A, Kirkpatrick JP, Braunstein S, Sneed P, Mehta MP. Estimating survival for renal cell carcinoma patients with brain metastases: an update of the Renal Graded Prognostic Assessment tool. Neuro-Oncology 2018, 20: 1652-1660. PMID: 30418657, PMCID: PMC6231200, DOI: 10.1093/neuonc/noy099.Peer-Reviewed Original ResearchConceptsPrognostic assessment toolsBrain metastasesRenal cell carcinomaMedian survivalPrognostic factorsAdditional significant prognostic factorsRenal cell carcinoma patientsRetrospective institutional review boardNew brain metastasesKarnofsky performance statusOverall median survivalCell carcinoma patientsSignificant prognostic factorsFuture clinical trialsClinical decision makingInstitutional review boardAssessment toolPerformance statusCommon complicationExtracranial metastasesHazard ratioCarcinoma patientsContemporary cohortRCC patientsWorse prognosis
2017
Prediction of new brain metastases after radiosurgery: validation and analysis of performance of a multi-institutional nomogram
Ayala-Peacock DN, Attia A, Braunstein SE, Ahluwalia MS, Hepel J, Chung C, Contessa J, McTyre E, Peiffer AM, Lucas JT, Isom S, Pajewski NM, Kotecha R, Stavas MJ, Page BR, Kleinberg L, Shen C, Taylor RB, Onyeuku NE, Hyde AT, Gorovets D, Chao ST, Corso C, Ruiz J, Watabe K, Tatter SB, Zadeh G, Chiang VLS, Fiveash JB, Chan MD. Prediction of new brain metastases after radiosurgery: validation and analysis of performance of a multi-institutional nomogram. Journal Of Neuro-Oncology 2017, 135: 403-411. PMID: 28828698, PMCID: PMC5667906, DOI: 10.1007/s11060-017-2588-4.Peer-Reviewed Original ResearchConceptsDistant brain failureWhole brain radiotherapyNew brain metastasesBrain metastasesStereotactic radiosurgeryRisk of DBFEarly whole brain radiotherapyPrognostic modelUpfront whole brain radiotherapyMulti-institutional nomogramNumber of metastasesHigh-risk thresholdSRS monotherapyMargin doseBrain radiotherapyBrain failureContemporary cohortPrognostic indexMelanoma histologyRelative riskAcademic centersMetastasisPatientsValidation datasetAbsolute numberLaser Thermal Ablation for Metastases Failing Radiosurgery: A Multicentered Retrospective Study
Chaunzwa TL, Deng D, Leuthardt EC, Tatter SB, Mohammadi AM, Barnett GH, Chiang VL. Laser Thermal Ablation for Metastases Failing Radiosurgery: A Multicentered Retrospective Study. Neurosurgery 2017, 82: 56-63. PMID: 28419284, DOI: 10.1093/neuros/nyx142.Peer-Reviewed Original ResearchConceptsRadiosurgical failureRadiation necrosisTumor regrowthAblation therapyFluid-attenuated inversion recovery signalTreatment factorsMulticentered retrospective studyKarnofsky performance statusMetastatic brain lesionsThermal ablation therapyLow complication rateTraditional treatment optionsTreatment of metastasesInversion recovery signalLaser thermal ablationBrain metastasesPreoperative symptomsComplication ratePerformance statusSymptomatic improvementSymptomatic reliefPerilesional edemaRetrospective studySurgical dataTreatment options
2016
Timing and type of immune checkpoint therapy affect the early radiographic response of melanoma brain metastases to stereotactic radiosurgery
Qian JM, Yu JB, Kluger HM, Chiang VL. Timing and type of immune checkpoint therapy affect the early radiographic response of melanoma brain metastases to stereotactic radiosurgery. Cancer 2016, 122: 3051-3058. PMID: 27285122, PMCID: PMC5030143, DOI: 10.1002/cncr.30138.Peer-Reviewed Original ResearchConceptsMedian percent reductionImmune checkpoint therapyLesional responseStereotactic radiosurgeryCheckpoint therapyLesion volumeAnti-cytotoxic T-lymphocyte-associated protein 4Anti-programmed cell death protein 1T-lymphocyte-associated protein 4Anti-PD-1 therapyGreater median percent reductionsCell death protein 1Administration of immunotherapyWeeks of immunotherapyMelanoma brain metastasesDeath protein 1Type of immunotherapyWilcoxon rank sum testRank sum testNonconcurrent therapyBrain metastasesMelanoma patientsTreatment of cancerSingle institutionPercent reductionPembrolizumab for patients with melanoma or non-small-cell lung cancer and untreated brain metastases: early analysis of a non-randomised, open-label, phase 2 trial
Goldberg SB, Gettinger SN, Mahajan A, Chiang AC, Herbst RS, Sznol M, Tsiouris AJ, Cohen J, Vortmeyer A, Jilaveanu L, Yu J, Hegde U, Speaker S, Madura M, Ralabate A, Rivera A, Rowen E, Gerrish H, Yao X, Chiang V, Kluger HM. Pembrolizumab for patients with melanoma or non-small-cell lung cancer and untreated brain metastases: early analysis of a non-randomised, open-label, phase 2 trial. The Lancet Oncology 2016, 17: 976-983. PMID: 27267608, PMCID: PMC5526047, DOI: 10.1016/s1470-2045(16)30053-5.Peer-Reviewed Original ResearchConceptsProgressive brain metastasesUntreated brain metastasesBrain metastasis responseYale Cancer CenterBrain metastasesPhase 2 trialCell lung cancerAdverse eventsMetastasis responseCancer CenterLung cancerMelanoma cohortGrade 3 colitisGrade 3 fatigueGrade 3 pneumonitisPD-1 axisAcute kidney injuryNeurological adverse eventsPD-1 inhibitorsAcceptable safety profilePD-L1 expressionSystemic immunotherapyKidney injuryPrimary endpointNSCLC cohort
2015
Extended Survival and Prognostic Factors for Patients With ALK-Rearranged Non–Small-Cell Lung Cancer and Brain Metastasis
Johung KL, Yeh N, Desai NB, Williams TM, Lautenschlaeger T, Arvold ND, Ning MS, Attia A, Lovly CM, Goldberg S, Beal K, Yu JB, Kavanagh BD, Chiang VL, Camidge DR, Contessa JN. Extended Survival and Prognostic Factors for Patients With ALK-Rearranged Non–Small-Cell Lung Cancer and Brain Metastasis. Journal Of Clinical Oncology 2015, 34: 123-129. PMID: 26438117, PMCID: PMC5070549, DOI: 10.1200/jco.2015.62.0138.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnaplastic Lymphoma KinaseAntineoplastic AgentsBrain NeoplasmsCarbazolesCarcinoma, Non-Small-Cell LungCranial IrradiationCrizotinibDisease-Free SurvivalFemaleFollow-Up StudiesGene RearrangementHumansKaplan-Meier EstimateKarnofsky Performance StatusLung NeoplasmsMaleMiddle AgedMolecular Targeted TherapyNeoplasm StagingPiperidinesPrognosisProtein Kinase InhibitorsProtein-Tyrosine KinasesPyrazolesPyridinesPyrimidinesRadiosurgeryReceptor Protein-Tyrosine KinasesRisk AssessmentRisk FactorsSmokingSulfonesConceptsIntracranial progression-free survivalBrain metastasesProgression-free survivalPrognostic factorsLung cancerMedian intracranial progression-free survivalNon-small cell lung cancerTyrosine kinase inhibitor therapyProgressive brain metastasesRefinement of prognosisKarnofsky performance scorePercent of patientsClinical prognostic factorsPopulation of patientsSingle brain metastasisCell lung cancerKinase inhibitor therapyCox proportional hazardsMulti-institutional studyMedian OSExtracranial metastasesImproved survivalInhibitor therapyInitial treatmentMultivariable analysisPost-radiosurgical edema associated with parasagittal and parafalcine meningiomas: a multicenter study
Sheehan JP, Cohen-Inbar O, Ruangkanchanasetr R, Bulent Omay S, Hess J, Chiang V, Iorio-Morin C, Alonso-Basanta M, Mathieu D, Grills IS, Lee JY, Lee CC, Dade Lunsford L. Post-radiosurgical edema associated with parasagittal and parafalcine meningiomas: a multicenter study. Journal Of Neuro-Oncology 2015, 125: 317-324. PMID: 26329323, DOI: 10.1007/s11060-015-1911-1.Peer-Reviewed Original ResearchConceptsStereotactic radiosurgeryParafalcine meningiomaTumor controlTumor volumeInternational Gamma Knife Research FoundationPost-surgical residual tumorAdjuvant stereotactic radiosurgeryRetrospective multicenter reviewTumor volume controlUpfront stereotactic radiosurgeryVenous sinus compressionMedian marginal doseMedian tumor volumeSubset of patientsLong-term followPeri-tumoral edemaExtent of edemaVenous sinus invasionMedian followMarginal doseMulticenter reviewPrognostic factorsSinus compressionResidual tumorMulticenter study
2014
Stereotactic radiosurgery of petroclival meningiomas: a multicenter study
Starke R, Kano H, Ding D, Nakaji P, Barnett GH, Mathieu D, Chiang V, Yu JB, Hess J, McBride HL, Honea N, Lee JY, Rahmathulla G, Evanoff WA, Alonso-Basanta M, Lunsford LD, Sheehan JP. Stereotactic radiosurgery of petroclival meningiomas: a multicenter study. Journal Of Neuro-Oncology 2014, 119: 169-176. PMID: 24821284, DOI: 10.1007/s11060-014-1470-x.Peer-Reviewed Original ResearchConceptsGamma knife radiosurgeryPetroclival meningiomasMulticenter studyFavorable outcomeTumor volumeActuarial progression-free survival ratesNorth American Gamma Knife ConsortiumProgression-free survival ratesFree survival ratePrimary treatment modalityProgression of symptomsSmaller tumor volumeComplete microsurgical resectionNeurological preservationUpfront radiosurgeryPrior radiotherapyMost patientsMicrosurgical resectionSignificant morbidityNeurological functionMaximal doseTumor controlTreatment modalitiesKnife radiosurgeryFemale genderGamma Knife radiosurgery for sellar and parasellar meningiomas: a multicenter study.
Sheehan JP, Starke RM, Kano H, Kaufmann AM, Mathieu D, Zeiler FA, West M, Chao ST, Varma G, Chiang VL, Yu JB, McBride HL, Nakaji P, Youssef E, Honea N, Rush S, Kondziolka D, Lee JY, Bailey RL, Kunwar S, Petti P, Lunsford LD. Gamma Knife radiosurgery for sellar and parasellar meningiomas: a multicenter study. Journal Of Neurosurgery 2014, 120: 1268-77. PMID: 24678777, DOI: 10.3171/2014.2.jns13139.Peer-Reviewed Original ResearchConceptsGamma knife radiosurgeryPrior radiation therapyParasellar meningiomasSellar meningiomasKnife radiosurgeryRadiation therapyPrior surgeryMulticenter studyTumor controlTumor volumeActuarial progression-free survival ratesNorth American Gamma Knife ConsortiumTumor progressionProgression-free survival ratesCox multivariate regression analysisTumor margin doseNew neurological deficitsCranial nerve deficitsPrimary treatment modalityKaplan-Meier analysisCranial nerves VLarger tumor volumeConventional radiation therapyMonths of imagingMultivariate regression analysis
2013
Survival and Intracranial Control of Patients With 5 or More Brain Metastases Treated With Gamma Knife Stereotactic Radiosurgery
Raldow AC, Chiang VL, Knisely JP, Yu JB. Survival and Intracranial Control of Patients With 5 or More Brain Metastases Treated With Gamma Knife Stereotactic Radiosurgery. American Journal Of Clinical Oncology 2013, 36: 486-490. PMID: 22706180, DOI: 10.1097/coc.0b013e31825494ef.Peer-Reviewed Original ResearchConceptsKarnofsky performance statusMore brain metastasesMedian overall survivalOverall survivalBrain metastasesRecurrence-free survivalStereotactic radiosurgeryWhole-brain radiation treatmentGamma Knife stereotactic radiosurgeryNumber of metastasesProportional hazards regressionGamma knife treatmentIntracranial controlOnly significant variableFree survivalIntracranial failurePerformance statusHazards regressionSurveillance imagingHistorical controlsDisease progressionRetrospective analysisPatientsFirst treatmentMetastasisStereotactic laser induced thermotherapy (LITT): a novel treatment for brain lesions regrowing after radiosurgery
Torres-Reveron J, Tomasiewicz HC, Shetty A, Amankulor NM, Chiang VL. Stereotactic laser induced thermotherapy (LITT): a novel treatment for brain lesions regrowing after radiosurgery. Journal Of Neuro-Oncology 2013, 113: 495-503. PMID: 23677747, DOI: 10.1007/s11060-013-1142-2.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBrain NeoplasmsFeasibility StudiesFemaleFollow-Up StudiesHumansHyperthermia, InducedImaging, Three-DimensionalLaser TherapyMagnetic Resonance ImagingMaleMiddle AgedNeoplasm Recurrence, LocalNeoplasmsPostoperative ComplicationsPrognosisRadiation InjuriesRadiosurgerySurvival RateConceptsNeurological symptomsBrain metastasesTreatment optionsStereotactic radiosurgeryWhole-brain radiation therapyGamma Knife stereotactic radiosurgeryBrain radiation therapyInitial favorable responseProgressive neurological symptomsAdverse radiation effectsNovel treatment optionsCases steroidsOngoing steroidsSymptom controlPatient comorbiditiesSurgical resectionSymptomatic reliefMetastatic lesionsRecurrent edemaRadiation necrosisBiopsy resultsDisease burdenMinimal morbidityBrain lesionsThermocoagulation proceduresEfficacy and Safety of Higher Dose Stereotactic Radiosurgery for Functional Pituitary Adenomas: A Preliminary Report
Grant RA, Whicker M, Lleva R, Knisely JP, Inzucchi SE, Chiang VL. Efficacy and Safety of Higher Dose Stereotactic Radiosurgery for Functional Pituitary Adenomas: A Preliminary Report. World Neurosurgery 2013, 82: 195-201. PMID: 23385448, DOI: 10.1016/j.wneu.2013.01.127.Peer-Reviewed Original ResearchMeSH KeywordsAdenomaAdolescentAdultAgedDose-Response Relationship, RadiationFemaleFollow-Up StudiesHumansHypopituitarismKaplan-Meier EstimateMagnetic Resonance ImagingMaleMiddle AgedNeoplasm Recurrence, LocalOptic NervePituitary HormonesPituitary NeoplasmsPostoperative ComplicationsProspective StudiesRadiosurgeryRetrospective StudiesSurvival AnalysisTreatment OutcomeYoung AdultConceptsSingle-fraction stereotactic radiosurgeryPituitary adenomasEndocrine remissionMarginal dosesStereotactic radiosurgeryHigh-dose stereotactic radiosurgeryCommon adjuvant therapyHigher marginal doseNew endocrine deficienciesOptic nerve pallorPost-SRS hypopituitarismRadiation-induced hypopituitarismSecretory pituitary adenomasHigh-dose treatmentFunctional pituitary adenomasRadiation-induced sequelaeActive pituitary adenomasFraction stereotactic radiosurgeryHormonal normalizationHormonal remissionAdjuvant therapyCranial neuropathiesMarginal doseEndocrine deficienciesSurgical resection
2008
Gamma Knife surgery for the treatment of melanoma metastases: the effect of intratumoral hemorrhage on survival.
Redmond AJ, DiLuna ML, Hebert R, Moliterno JA, Desai R, Knisely JP, Chiang VL. Gamma Knife surgery for the treatment of melanoma metastases: the effect of intratumoral hemorrhage on survival. Journal Of Neurosurgery 2008, 109 Suppl: 99-105. PMID: 19123895, DOI: 10.3171/jns/2008/109/12/s16.Peer-Reviewed Original ResearchConceptsGamma Knife surgeryMelanoma metastasesIntratumoral bleedingTime of GKSWhole-brain radiation therapyPost-GKS hemorrhageMelanoma brain metastasesRate of hemorrhageConnecticut Tumor RegistryMalignant melanoma metastaticSurvival of patientsTotal tumor volumeTreatment-specific factorsMelanoma metastaticPosttreatment bleedingAntithrombotic medicationBrain metastasesMetastasis locationOverall survivalSolitary metastasisTumor RegistryTumor burdenWorse prognosisIntracranial metastasesPatient survival