2023
SURG-32. EFFICACY OF LASER INTERSTITIAL THERMAL THERAPY (LITT) FOR BIOPSY-PROVEN RADIATION NECROSIS IN RADIOGRAPHICALLY RECURRENT BRAIN METASTASES
Strowd R, Chan M, Tatter S, Chiang V, Fecci P, Prabhu S, Hadjipanayis C, Kirkpatrick J, Sun D, Sinicrope K, Mohammadi A, Sevak P, Abram S, Kim A, Leuthardt E, Chao S, Phillips J, Lacroix M, Williams B, Placantonakis D, Silverman J, Baumgartner J, Piccioni D, Laxton A. SURG-32. EFFICACY OF LASER INTERSTITIAL THERMAL THERAPY (LITT) FOR BIOPSY-PROVEN RADIATION NECROSIS IN RADIOGRAPHICALLY RECURRENT BRAIN METASTASES. Neuro-Oncology 2023, 25: v269-v269. PMCID: PMC10640195, DOI: 10.1093/neuonc/noad179.1031.Peer-Reviewed Original ResearchLaser interstitial thermal therapyKarnofsky performance statusRadiation necrosisInterstitial thermal therapyBrain metastasesRadiographic progressionKaplan-MeierStereotactic radiosurgeryLocal controlMedian Karnofsky performance statusFuture radiographic progressionRadiotherapeutic treatment optionsResults Ninety patientsBrain metastasis patientsMulti-center registryRecurrent brain metastasesMedian hospitalization timeLesional progressionMultivariable FineNinety patientsSymptom controlCumulative incidenceMetastasis patientsPerformance statusSystemic therapyLocal Control and Survival Outcomes After Stereotactic Radiosurgery for Brain Metastases From Gastrointestinal Primaries: An International Multicenter Analysis
Singh R, Bowden G, Mathieu D, Perlow H, Palmer J, Elhamdani S, Shepard M, Liang Y, Nabeel A, Reda W, Tawadros S, Abdelkarim K, El-Shehaby A, Emad R, Elazzazi A, Warnick R, Gozal Y, Daly M, McShane B, Addis-Jackson M, Karthikeyan G, Smith S, Picozzi P, Franzini A, Kaisman-Elbaz T, Yang H, Wei Z, Legarreta A, Hess J, Templeton K, Pikis S, Mantziaris G, Simonova G, Liscak R, Peker S, Samanci Y, Chiang V, Niranjan A, Kersh C, Lee C, Trifiletti D, Lunsford L, Sheehan J. Local Control and Survival Outcomes After Stereotactic Radiosurgery for Brain Metastases From Gastrointestinal Primaries: An International Multicenter Analysis. Neurosurgery 2023, 93: 592-598. PMID: 36942965, DOI: 10.1227/neu.0000000000002456.Peer-Reviewed Original ResearchConceptsKarnofsky performance statusStereotactic radiosurgeryOverall survivalBrain metastasesUnivariate analysisLocal controlGI primaryExtracranial metastasesPrognostic factorsBrain metastases treated with stereotactic radiosurgeryAssociated with inferior LCAssociated with inferior OSMedian Karnofsky performance statusEvaluate potential prognostic factorsInternational multicenter analysisPlanning target volumePotential prognostic factorsKaplan-Meier analysisOne-yearProportional hazards modelInferior LCInferior OSOS ratesLC ratesGastrointestinal primaryEfficacy of laser interstitial thermal therapy for biopsy-proven radiation necrosis in radiographically recurrent brain metastases
Chan M, Tatter S, Chiang V, Fecci P, Strowd R, Prabhu S, Hadjipanayis C, Kirkpatrick J, Sun D, Sinicrope K, Mohammadi A, Sevak P, Abram S, Kim A, Leuthardt E, Chao S, Phillips J, Lacroix M, Williams B, Placantonakis D, Silverman J, Baumgartner J, Piccioni D, Laxton A. Efficacy of laser interstitial thermal therapy for biopsy-proven radiation necrosis in radiographically recurrent brain metastases. Neuro-Oncology Advances 2023, 5: vdad031. PMID: 37114245, PMCID: PMC10129388, DOI: 10.1093/noajnl/vdad031.Peer-Reviewed Original ResearchLaser interstitial thermal therapyKarnofsky performance statusRadiation necrosisInterstitial thermal therapyBrain metastasesLocal controlMedian Karnofsky performance statusRecurrent brain metastasesMedian hospitalization timeLow patient morbidityLesional progressionMultivariable FineCumulative incidenceOverall survivalPerformance statusSymptom controlHospitalization timeSystemic therapyMedian timeNeurological deathSymptom managementKaplan-MeierPatient morbiditySeizure prevalenceUS Centers
2022
Stereotactic radiosurgery and local control of brain metastases from triple-negative breast cancer.
Kowalchuk R, Niranjan A, Hess J, Antonios J, Zhang M, Braunstein S, Ross R, Pikis S, Deibert C, Lee C, Yang H, Langlois A, Mathieu D, Peker S, Samanci Y, Rusthoven C, Chiang V, Wei Z, Lunsford L, Trifiletti D, Sheehan J. Stereotactic radiosurgery and local control of brain metastases from triple-negative breast cancer. Journal Of Neurosurgery 2022, 138: 1608-1614. PMID: 36433878, DOI: 10.3171/2022.10.jns221900.Peer-Reviewed Original ResearchTriple-negative breast cancerLocal tumor progressionStereotactic radiosurgeryBreast cancerOverall survivalMetastatic lesionsPerformance statusLocal controlTriple-negative breast cancer metastasisMedian Karnofsky performance statusTumor progressionWhole-brain radiation therapyFavorable performance statusMedian margin dosePrior stereotactic radiosurgerySymptomatic radiation necrosisKarnofsky performance statusIntracranial metastatic diseaseRetrospective chart reviewLocal tumor controlBreast cancer metastasisIntracranial metastatic lesionsMargin doseMultiinstitutional cohortBrain metastases
2021
SURG-02. Stereotactic Laser Ablation (SLA) followed by consolidation stereotactic radiosurgery (SRS) as a treatment strategy for brain metastasis that recurred locally after initial radiosurgery (BMRS): a collaborative institutional experience
Pena-Pino I, Ma J, Hori Y, Fomchenko E, Dusenbery K, Reynolds M, Wilke C, Yuan J, Barnett G, Chiang V, Mohammadi A, Chen C. SURG-02. Stereotactic Laser Ablation (SLA) followed by consolidation stereotactic radiosurgery (SRS) as a treatment strategy for brain metastasis that recurred locally after initial radiosurgery (BMRS): a collaborative institutional experience. Neuro-Oncology Advances 2021, 3: iii23-iii23. PMCID: PMC8351296, DOI: 10.1093/noajnl/vdab071.095.Peer-Reviewed Original ResearchStereotactic laser ablationStereotactic radiosurgeryOverall survivalTreatment strategiesLocal controlDays of SRSSymptomatic radiation necrosisMedian overall survivalSystemic disease progressionRepeat stereotactic radiosurgeryIndependent clinical trialsInitial radiosurgerySteroid therapyBrain metastasesClinical outcomesRadiation necrosisFavorable outcomeClinical trialsDisease progressionFLAIR volumeInstitutional experiencePatientsCE volumeRadiosurgeryLocal failure
2019
SURG-06. LASER INTERSTITIAL THERMAL THERAPY COMPARED TO CRANIOTOMY FOR TREATMENT OF RADIATION NECROSIS OR RECURRENT TUMOR IN BRAIN METASTASES FAILING RADIOSURGERY
Hong C, Deng D, Sujijantarat N, Vera A, Chiang V. SURG-06. LASER INTERSTITIAL THERMAL THERAPY COMPARED TO CRANIOTOMY FOR TREATMENT OF RADIATION NECROSIS OR RECURRENT TUMOR IN BRAIN METASTASES FAILING RADIOSURGERY. Neuro-Oncology Advances 2019, 1: i31-i32. PMCID: PMC7213364, DOI: 10.1093/noajnl/vdz014.141.Peer-Reviewed Original ResearchLaser interstitial thermal therapyProgression-free survivalBrain metastasesRadiation necrosisOverall survivalStereotactic radiosurgeryRecurrent tumorsSingle-institution chart reviewPost-operative salvagePre-operative symptomsSub-group analysisViable alternative treatmentRe-growing tumorSteroid taperNeurological outcomeChart reviewSymptom reliefUnderwent craniotomyTumor lesionsAlternative treatmentCraniotomyLocal controlPatientsMetastasisSmall lesionsStereotactic Laser Ablation as Treatment of Brain Metastases Recurring after Stereotactic Radiosurgery: A Systematic Literature Review
Alattar AA, Bartek J, Chiang VL, Mohammadi AM, Barnett GH, Sloan A, Chen CC. Stereotactic Laser Ablation as Treatment of Brain Metastases Recurring after Stereotactic Radiosurgery: A Systematic Literature Review. World Neurosurgery 2019, 128: 134-142. PMID: 31051303, DOI: 10.1016/j.wneu.2019.04.200.Peer-Reviewed Original ResearchConceptsStereotactic laser ablationLocal controlContrast-enhancing volumeBrain metastasesFluid-attenuated inversion recovery volumeMalignant cerebral edemaPermanent neurologic injuryPreoperative lesion volumeMedian hospital stayDuration of therapyPotential treatment optionPercentage of tumorsHours of treatmentHospital stayNeurologic outcomePeriprocedural managementCerebral edemaCommon complicationMedian survivalNeurologic deficitsNeurologic injuryOverall survivalClinical courseTreatment optionsOptimal treatmentLaser-interstitial thermal therapy compared to craniotomy for treatment of radiation necrosis or recurrent tumor in brain metastases failing radiosurgery
Hong CS, Deng D, Vera A, Chiang VL. Laser-interstitial thermal therapy compared to craniotomy for treatment of radiation necrosis or recurrent tumor in brain metastases failing radiosurgery. Journal Of Neuro-Oncology 2019, 142: 309-317. PMID: 30656529, DOI: 10.1007/s11060-019-03097-z.Peer-Reviewed Original ResearchConceptsLaser interstitial thermal therapyProgression-free survivalBrain metastasesRadiation necrosisOverall survivalStereotactic radiosurgeryRecurrent tumorsSingle-institution chart reviewPost-operative salvageResultsOf 75 patientsPre-operative symptomsViable alternative treatmentRe-growing tumorSteroid taperNeurological outcomeChart reviewSymptom reliefUnderwent craniotomySubgroup analysisTumor lesionsAlternative treatmentCraniotomyLocal controlMetastasisPatientsResults of a pilot/phase II study of gamma knife radiosurgery for brain metastases and implications for future prospective clinical trials
Yu J, Singh C, Bindra R, Contessa J, Husain Z, Hansen J, Park H, Roberts K, Bond J, Tien C, Guo F, Colaco R, Housri N, Magnuson W, Mahajan A, Omay S, Chiang V. Results of a pilot/phase II study of gamma knife radiosurgery for brain metastases and implications for future prospective clinical trials. Journal Of Radiation Oncology 2019, 8: 39-46. DOI: 10.1007/s13566-018-0370-7.Peer-Reviewed Original ResearchYale-New Haven HospitalPhase II studyBrain metastasesClinical trialsII studyKnife radiosurgeryLocal controlPre-defined primary endpointWhole-brain radiation treatmentFuture prospective clinical trialsEvaluable brain metastasesSymptomatic radiation necrosisMedian patient ageLocal control ratePhase 2 studyGood local controlProspective clinical trialsNumber of metastasesLarge clinical trialsProportional hazards regressionFuture clinical trialsGamma knife radiosurgeryImportant clinical variablesStandard clinical practiceNew Haven Hospital
2018
SURG-20. LASER-INTERSTITIAL THERMAL THERAPY VERSUS CRANIOTOMY FOR TREATMENT OF RADIATION NECROSIS OR RECURRENT TUMOR IN BRAIN METASTASES FAILING RADIOSURGERY
Hong C, Deng J, Vera A, Chiang V. SURG-20. LASER-INTERSTITIAL THERMAL THERAPY VERSUS CRANIOTOMY FOR TREATMENT OF RADIATION NECROSIS OR RECURRENT TUMOR IN BRAIN METASTASES FAILING RADIOSURGERY. Neuro-Oncology 2018, 20: vi254-vi255. PMCID: PMC6216306, DOI: 10.1093/neuonc/noy148.1056.Peer-Reviewed Original ResearchLaser interstitial thermal therapyProgression-free survivalRe-growing tumorRadiation necrosisBrain metastasesMelanoma patientsSingle-surgeon retrospective studyImproved progression-free survivalLocal progression-free survivalPre-operative symptomsLog-rank testSteroid dosingSteroid taperNeurological outcomeOverall survivalRecurrent tumorsUnderwent craniotomyRetrospective studySingle institutionSubgroup analysisSurgery dateSurvival advantageCraniotomyPatientsLocal controlSingle versus Multifraction Stereotactic Radiosurgery for Large Brain Metastases: An International Meta-analysis of 24 Trials
Lehrer EJ, Peterson JL, Zaorsky NG, Brown PD, Sahgal A, Chiang VL, Chao ST, Sheehan JP, Trifiletti DM. Single versus Multifraction Stereotactic Radiosurgery for Large Brain Metastases: An International Meta-analysis of 24 Trials. International Journal Of Radiation Oncology • Biology • Physics 2018, 103: 618-630. PMID: 30395902, DOI: 10.1016/j.ijrobp.2018.10.038.Peer-Reviewed Original ResearchConceptsLarge brain metastasesMF-SRSSF-SRSMultifraction stereotactic radiosurgeryBrain metastasesRandom effects estimatesStereotactic radiosurgeryLocal controlMeta-AnalysisEffect estimatesRates of radionecrosisProspective clinical trialsPreferred Reporting ItemsRadionecrosis ratePostoperative settingTumor sizeInternational Meta-AnalysisEpidemiology guidelinesClinical trialsObservational studyRandom effectsTumor volumeSummary estimatesReporting ItemsMetastasis
2016
Spine Stereotactic Body Radiotherapy Outcomes in Patients with Concurrent Brain Metastases
Colaco RJ, Park HS, Laurans MS, Chiang VS, Yu JB, Husain ZA. Spine Stereotactic Body Radiotherapy Outcomes in Patients with Concurrent Brain Metastases. Cureus 2016, 8: e679. PMID: 27563505, PMCID: PMC4985044, DOI: 10.7759/cureus.679.Peer-Reviewed Original ResearchSpine stereotactic body radiotherapyConcurrent brain metastasisStereotactic body radiotherapyOverall survivalSpine metastasesLocal controlBrain metastasesMultivariable analysisOne-year local controlOne-year overall survivalCox proportional hazards regressionMedian patient ageProportional hazards regressionLog-rank testMann-Whitney testCBM patientsSurvival prognosticatorPain controlComplete stagingPatient ageSpinal metastasesClinical outcomesHazards regressionRadioresistant histologiesBody radiotherapyDemonstration of differential radiosensitivity based upon mutation profile in metastatic melanoma treated with stereotactic radiosurgery.
Rutter CE, Johung KL, Yao X, Lu AY, Jilaveanu LB, Yu JB, Contessa JN, Kluger HM, Chiang VLS, Bindra RS. Demonstration of differential radiosensitivity based upon mutation profile in metastatic melanoma treated with stereotactic radiosurgery. Journal Of Radiosurgery And SBRT 2016, 4: 97-106. PMID: 29296434, PMCID: PMC5658871.Peer-Reviewed Original ResearchWild-type patientsC-kit mutationsLocal recurrenceMetastatic melanomaBrain metastasesType patientsN-RASCox proportional hazards modelMelanoma brain metastasesImproved local controlLocal recurrence rateProportional hazards modelN-RAS mutationsB-RafDifferential radiosensitivityDistant failureRecurrence rateImportant treatmentStereotactic radiosurgeryHazards modelPatientsLocal controlMultivariate analysisStandardized imagingRecurrence
2014
Significance of histology in determining management of lesions regrowing after radiosurgery
Nath SK, Sheridan AD, Rauch PJ, Yu JB, Minja FJ, Vortmeyer AO, Chiang VL. Significance of histology in determining management of lesions regrowing after radiosurgery. Journal Of Neuro-Oncology 2014, 117: 303-310. PMID: 24504499, DOI: 10.1007/s11060-014-1389-2.Peer-Reviewed Original ResearchConceptsBrain metastasesTumor cellsLocal controlSignificance of histologyWorse local controlResidual tumor cellsPost-treatment imagingManagement of lesionsOngoing patient managementInflammatory changesClinical outcomesResidual tumorSymptomatic enlargementAmbiguous etiologyHistologic findingsPatient outcomesPatient managementBrain specimensStereotactic radiosurgeryHistopathologic interpretationLesionsTissue specimensResectionPatientsMetastasis
2013
A Clinical Model for Identifying Radiosensitive Tumor Genotypes in Non–Small Cell Lung Cancer
Johung KL, Yao X, Li F, Yu JB, Gettinger SN, Goldberg S, Decker RH, Hess JA, Chiang VL, Contessa JN. A Clinical Model for Identifying Radiosensitive Tumor Genotypes in Non–Small Cell Lung Cancer. Clinical Cancer Research 2013, 19: 5523-5532. PMID: 23897899, DOI: 10.1158/1078-0432.ccr-13-0836.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnaplastic Lymphoma KinaseAntineoplastic AgentsBrain NeoplasmsCarcinoma, Non-Small-Cell LungErbB ReceptorsFemaleGenotypeHumansLung NeoplasmsMaleMiddle AgedMutationProtein Kinase InhibitorsRadiation ToleranceReceptor Protein-Tyrosine KinasesRecurrenceTranslocation, GeneticTumor BurdenConceptsNon-small cell lung cancerCell lung cancerEML4-ALK translocationGamma knife treatmentLocal controlTumor genotypeLung cancerEGFR mutationsCox proportional hazards modelDistant brain controlDistant brain recurrenceGamma knife radiotherapyEGFR kinase domain mutationsSuperior local controlField local controlKRAS mutation statusProportional hazards modelKinase domain mutationsEGF receptorMetastasis sizeBrain recurrenceBrain metastasesField recurrenceClinical outcomesIndependent predictors