2024
154 Elucidating the Immune Landscape of Radiation Necrosis Through Single Cell Analysis of Recurrent Brain Lesions in Patients After Stereotactic Radio Surgery
Robert S, Kiziltug E, Lu B, Arnal-Estape A, Nguyen D, Chiang V. 154 Elucidating the Immune Landscape of Radiation Necrosis Through Single Cell Analysis of Recurrent Brain Lesions in Patients After Stereotactic Radio Surgery. Neurosurgery 2024, 70: 35-36. DOI: 10.1227/neu.0000000000002809_154.Peer-Reviewed Original ResearchRadiation necrosisFluorescence-activated cell sortingInterferon-stimulated genesStereotactic radiosurgeryNatural killerMyeloid cellsImmune cellsRadiosurgical treatment of brain metastasesTreatment of brain metastasesCD4+ T cellsExpression of immune cellsMorbid side effectsTreatment of RNSubpopulations of myeloid cellsStereotactic radio surgeryMetastatic brain tumorsInvasive brain biopsyCellular immune profilesInflammatory immune responseCSF of patientsRN patientsBrain metastasesCD8+Immunotherapy optionsMetastatic tumors
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 therapySelected-Lesion Stereotactic Radiosurgery in Treatment of Patients with Multiple Brain Metastases: A Single Institution Retrospective Study
Mange A, Singh C, Theriault B, Hansen J, An Y, Aneja S, Chiang V. Selected-Lesion Stereotactic Radiosurgery in Treatment of Patients with Multiple Brain Metastases: A Single Institution Retrospective Study. International Journal Of Radiation Oncology • Biology • Physics 2023, 117: e135. DOI: 10.1016/j.ijrobp.2023.06.939.Peer-Reviewed Original ResearchMultiple brain metastasesBrain metastasesStereotactic radiosurgeryMedian KPSCommon indicationTumor characteristicsClinical trialsSRS treatmentSingle-institution retrospective studySubsequent-line treatmentMethods Clinical dataPatient selection criteriaTreatment of patientsSubset of lesionsNumber of lesionsDiagnosis of melanomaCNS progressionCNS radiationPrior WBRTOverall survivalPalliative treatmentPatient characteristicsProgressive diseaseImmunotherapy trialsSurvival groupSelected-Lesion Stereotactic Radiosurgery (SL-SRS) as a Novel Strategy in the Treatment of Patients With Multiple Brain Metastases
Theriault B, Singh C, Yu J, Knisely J, Shepard M, Wegner R, Warnick R, Peker S, Samanci Y, Trifiletti D, Lee C, Yang H, Bernstein K, Kondziolka D, Tripathi M, Mathieu D, Mantziaris G, Pikis S, Sheehan J, Chiang V. Selected-Lesion Stereotactic Radiosurgery (SL-SRS) as a Novel Strategy in the Treatment of Patients With Multiple Brain Metastases. Cureus 2023, 15: e45457. PMID: 37859877, PMCID: PMC10583225, DOI: 10.7759/cureus.45457.Peer-Reviewed Original ResearchWhole brain radiotherapyInternational Radiosurgery Research FoundationPrior whole brain radiotherapyBrain metastasesStereotactic radiosurgeryCommon reasonAsymptomatic brain metastasesNon-eloquent locationsSystemic treatment optionsMultiple brain metastasesPoor functional statusTreatment of patientsCentral nervous systemAttributable symptomsExtracranial diseaseSystemic therapyUntreated lesionsMedical oncologySystemic diseaseFunctional statusTreatment optionsClinical trialsSingle lesionLesion locationIntracranial lesionsUse of stereotactic radiosurgery in treatment of brain metastases from pediatric extracranial solid tumors
Xu S, Campbell A, Chiang V, Bindra R, Vasquez J, Pashankar F. Use of stereotactic radiosurgery in treatment of brain metastases from pediatric extracranial solid tumors. Pediatric Blood & Cancer 2023, 70: e30303. PMID: 36975152, DOI: 10.1002/pbc.30303.Peer-Reviewed Original ResearchLocal 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 primaryManagement of patients with brain metastases from NSCLC without a genetic driver alteration: upfront radiotherapy or immunotherapy?
Merkin R, Chiang V, Goldberg S. Management of patients with brain metastases from NSCLC without a genetic driver alteration: upfront radiotherapy or immunotherapy? Therapeutic Advances In Medical Oncology 2023, 15: 17588359231175438. PMID: 37275964, PMCID: PMC10233588, DOI: 10.1177/17588359231175438.Peer-Reviewed Original ResearchImmune checkpoint inhibitorsBrain metastasesTargetable genetic alterationsLocal therapyLung cancerStereotactic radiosurgeryDeath 1 ligand 1 expressionManagement of BMSole metastatic siteStage IV diseaseWhole brain radiotherapyLigand 1 expressionPD-L1 expressionProspective clinical trialsTime of diagnosisManagement of patientsCell lung cancerCancer-related deathGenetic alterationsCentral nervous systemGenetic driver alterationsAnaplastic lymphoma kinaseEpidermal growth factor receptorGrowth factor receptorUpfront radiotherapy
2022
Multicenter analysis of stereotactic radiosurgery for multiple brain metastases from EGFR and ALK driven non-small cell lung cancer
Wandrey N, Gao D, Robin T, Contessa J, Singh C, Chiang V, Li J, Chen A, Wang Y, Sheehan J, Dutta S, Weiss S, Paly J, Rusthoven C. Multicenter analysis of stereotactic radiosurgery for multiple brain metastases from EGFR and ALK driven non-small cell lung cancer. Lung Cancer 2022, 176: 144-148. PMID: 36641932, PMCID: PMC10552603, DOI: 10.1016/j.lungcan.2022.11.019.Peer-Reviewed Original ResearchConceptsNon-small cell lung cancerOverall survivalCell lung cancerStereotactic radiosurgeryBrain metastasesMultivariable adjustmentMulticenter analysisLung cancerNext-generation tyrosine kinase inhibitorsSRS treatmentOnly negative prognostic factorWhole brain radiotherapyMedian overall survivalMultiple brain metastasesNegative prognostic factorFavorable overall survivalTyrosine kinase inhibitorsTreatment 1CNS progressionMulticenter outcomesMedian followPrognostic factorsFavorable prognosisCNS diseaseTreatment optionsStereotactic 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 metastasesNIMG-07. APPLYING A GLIOMA-TRAINED DEEP LEARNING AUTO-SEGMENTATION TOOL ON BM PRE- AND POST-RADIOSURGERY
Kaur M, Varghese S, Jekel L, Tillmanns N, Merkaj S, Bousabarah K, Lin M, Bhawnani J, Chiang V, Aboian M. NIMG-07. APPLYING A GLIOMA-TRAINED DEEP LEARNING AUTO-SEGMENTATION TOOL ON BM PRE- AND POST-RADIOSURGERY. Neuro-Oncology 2022, 24: vii162-vii163. PMCID: PMC9660643, DOI: 10.1093/neuonc/noac209.626.Peer-Reviewed Original ResearchStereotactic radiosurgeryPosttreatment lesionsBoard-certified neuroradiologistsRoutine clinical useWhole tumorTumor coreMulticentric lesionsTreatment responsePeritumoral edemaBM preLesionsClinical useVolumetric segmentationEdemaPatientsT2w FLAIRTherapy planningTumorsDedicated trainingLesion detectionBM dataVolumetric measurementsBMMRIPreHistological changes associated with laser interstitial thermal therapy for radiation necrosis: illustrative cases
Fomchenko EI, Leelatian N, Darbinyan A, Huttner AJ, Chiang VL. Histological changes associated with laser interstitial thermal therapy for radiation necrosis: illustrative cases. Journal Of Neurosurgery Case Lessons 2022, 4: case21373. PMID: 35855352, PMCID: PMC9257400, DOI: 10.3171/case21373.Peer-Reviewed Original ResearchLaser interstitial thermal therapyRadiation necrosisInterstitial thermal therapyBrain metastasesAssociated cerebral edemaStage IV diseaseUse of immunotherapyPredictors of responseOngoing immunotherapySurgical decompressionCerebral edemaPerilesional edemaSurgical approachClinical historyLung cancerNeurological compromiseGood patientHistological changesStereotactic radiosurgeryPatientsEarly reductionSized lesionsImmunotherapyTherapyThermal therapySynchronous glioblastoma and brain metastases: illustrative case
Shahsavari N, Ahmad M, Sekar V, Meola A, Hancock SL, Chang SD, Chiang VL. Synchronous glioblastoma and brain metastases: illustrative case. Journal Of Neurosurgery Case Lessons 2022, 3: case21714. PMID: 36273867, PMCID: PMC9379681, DOI: 10.3171/case21714.Peer-Reviewed Original ResearchBrain metastasesMultiple brain metastasesRadiosurgical treatmentSignificant perilesional edemaSimilar radiological featuresMetastatic lung adenocarcinomaRight temporal lobeStereotactic radiosurgical treatmentMaintenance nivolumabRadiological featuresMidline shiftPerilesional edemaTreatment courseTissue confirmationLung adenocarcinomaStereotactic radiosurgeryTemporal lobeMetastasisIllustrative caseIncorrect diagnosisRadiological surveillanceSynchronous presenceIDH-wildtypeGlioblastomaLesionsFactors associated with progression and mortality among patients undergoing stereotactic radiosurgery for intracranial metastasis: results from a national real-world registry.
Alvi MA, Asher AL, Michalopoulos GD, Grills IS, Warnick RE, McInerney J, Chiang VL, Attia A, Timmerman R, Chang E, Kavanagh BD, Andrews DW, Walter K, Bydon M, Sheehan JP. Factors associated with progression and mortality among patients undergoing stereotactic radiosurgery for intracranial metastasis: results from a national real-world registry. Journal Of Neurosurgery 2022, 137: 985-998. PMID: 35171833, DOI: 10.3171/2021.10.jns211410.Peer-Reviewed Original ResearchMultivariable Cox proportional hazards analysisCox proportional hazards analysisAdministration of immunotherapyProportional hazards analysisStereotactic radiosurgeryIntracranial metastatic lesionsMetastatic lesionsOverall progressionLesion responseInitial stereotactic radiosurgeryMultifraction stereotactic radiosurgeryProgressive intracranial diseaseNeuro-Oncology criteriaOutcomes of patientsReal-world registryResponse Evaluation CriteriaGood local controlIntracranial metastatic diseaseKaplan-Meier analysisCommon primary tumorHazard of progressionLarger lesion sizeSingle-fraction treatmentLesion regressionMedian survivalReal-time PACS-integrated longitudinal brain metastasis tracking tool provides comprehensive assessment of treatment response to radiosurgery
Petersen G, Bousabarah K, Verma T, von Reppert M, Jekel L, Gordem A, Jang B, Merkaj S, Fadel S, Owens R, Omuro A, Chiang V, Ikuta I, Lin M, Aboian MS. Real-time PACS-integrated longitudinal brain metastasis tracking tool provides comprehensive assessment of treatment response to radiosurgery. Neuro-Oncology Advances 2022, 4: vdac116. PMID: 36043121, PMCID: PMC9412827, DOI: 10.1093/noajnl/vdac116.Peer-Reviewed Original ResearchGamma KnifeTreatment responseBrain metastasis patientsFurther treatment planningNumber of lesionsMean followBrain metastasesMetastasis patientsMultiple lesionsDiagnostic followSingle patientStereotactic radiosurgeryPatientsLesionsIndividual lesionsPrevalenceAccurate surveillanceHeterogenous responseTreatment planningTreatmentFollowRadiosurgerySize assessmentComprehensive assessmentResponse
2021
Recognition and Management of Adverse Radiation Effects
Cheok S, Hansen J, Chiang V. Recognition and Management of Adverse Radiation Effects. 2021, 391-404. DOI: 10.1201/9781003167464-36.ChaptersAdverse radiation effectsRadiation necrosisStereotactic radiosurgeryRole of SRSImmune-mediated componentLaser interstitial thermotherapyMore brain lesionsBrain metastasesSystemic therapyIntracranial pathologyMalignant pathologyBrain lesionsNecrosisInterstitial thermotherapyPathologyContemporary evidenceBevacizumabCraniotomyMetastasisTherapyLesionsRadiosurgerySteroidsReirradiation With Stereotactic Radiosurgery After Local or Marginal Recurrence of Brain Metastases From Previous Radiosurgery
Kowalchuk RO, Niranjan A, Lee CC, Yang HC, Liscak R, Guseynova K, Tripathi M, Kumar N, Peker S, Samanci Y, Hess J, Chiang V, Iorio-Morin C, Mathieu D, Pikis S, Wei Z, Lunsford LD, Trifiletti DM, Sheehan JP. Reirradiation With Stereotactic Radiosurgery After Local or Marginal Recurrence of Brain Metastases From Previous Radiosurgery. International Journal Of Radiation Oncology • Biology • Physics 2021, 112: 726-734. PMID: 34644606, DOI: 10.1016/j.ijrobp.2021.10.008.Peer-Reviewed Original ResearchConceptsLocal tumor controlRepeat stereotactic radiosurgeryRadiation necrosisStereotactic radiosurgeryBrain metastasesTumor controlMaximum doseMarginal recurrenceBiopsy-proven non-small cell lung cancerIsodose lineNon-small cell lung cancerRisk of RNPreoperative stereotactic radiosurgeryPrior stereotactic radiosurgerySymptomatic radiation necrosisNeuro-Oncology criteriaCell lung cancerPrescription isodose linePrevious radiosurgeryMargin dosePrimary endpointPrior immunotherapyLung cancerMajor indicationTumor volumeAdverse 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 ResearchConceptsAdverse 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 radiosurgeryPatientsSURG-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 failureOutcomes of Stereotactic Radiosurgery and Immunotherapy in Renal Cell Carcinoma Patients With Brain Metastases
Uezono H, Nam D, Kluger HM, Sznol M, Hurwitz M, Yu JB, Chiang VL. Outcomes of Stereotactic Radiosurgery and Immunotherapy in Renal Cell Carcinoma Patients With Brain Metastases. American Journal Of Clinical Oncology 2021, 44: 495-501. PMID: 34432667, DOI: 10.1097/coc.0000000000000849.Peer-Reviewed Original ResearchConceptsImmune checkpoint inhibitorsRCC brain metastasesBrain metastasesRenal cell carcinomaStereotactic radiosurgeryOverall survivalUse of ICIsCentral nervous system toxicityRenal cell carcinoma patientsImpact of immunotherapyLocal control outcomesMedian overall survivalCell carcinoma patientsKaplan-Meier curvesNervous system toxicityBetter median OSLog-rank testMann-Whitney U testMargin doseMedian OSNonimmunotherapy groupSRS doseCheckpoint inhibitorsImmunotherapy groupCarcinoma patientsIntracranial Complications From Immune Checkpoint Therapy in a Patient With NSCLC and Multiple Sclerosis: Case Report
Lu BY, Isitan C, Mahajan A, Chiang V, Huttner A, Mitzner JR, Wesley SF, Goldberg SB. Intracranial Complications From Immune Checkpoint Therapy in a Patient With NSCLC and Multiple Sclerosis: Case Report. JTO Clinical And Research Reports 2021, 2: 100183. PMID: 34590030, PMCID: PMC8474265, DOI: 10.1016/j.jtocrr.2021.100183.Peer-Reviewed Original ResearchImmune checkpoint inhibitorsMultiple sclerosisRadiation necrosisBrain lesionsWhole-brain radiation therapyImmune checkpoint therapyViable tumor cellsPaucity of dataBrain metastasesCheckpoint inhibitorsMetastatic NSCLCAdverse eventsCheckpoint therapyDurable responsesNeurologic declineRadiographic benefitIntracranial complicationsPathologic findingsAutoimmune disordersAutoimmune diseasesCase reportIntracranial diseaseRadiation therapyStereotactic radiosurgeryAnticancer benefits