A Comparison Between Cyberknife And Neurosurgery In Solitary Brain Metastases From Non-small Cell Lung Cancer

Purpose:To evaluate the efficacy of cyberknife (CK) and neurosurgery (NS) in patients newly diagnosed as solitary brain metastasis (SBM) from non-small cell lung cancer (NSCLC).Methods and Materials:We retrospectively analyzed76patients between1990and2012from our institution, including38patients performing CK and the other half performing NS. The observation end point was overall survival time (OS), local control of treated metastasis (LC) and intracranial control (IC). Kaplan-Meier OS curves were compared with the log-rank test. Cox regression analysis was used to determine prognosticators for OS, LC and IC.Results:The baseline characteristic between the two groups was not significantly different. The1-year OS rates were53.5%and30.5%in the CK group and NS group respectively (p=0.121). The1-year LC rates were50.8%and31.3%, respectively (p=0.078).The1-year IC rates were50.8%and27.7%, respectively (p=0.066). In multivariate analysis, improved OS was significantly associated with younger age (<60)0=0.016), better ECOG performance status (0-1)(p=0.000) and graded prognostic assessment (GPA,3.5-4.0,p=0.006). The LC was also associated with better ECOG performance status (p=0.000). The IC was associated with both better ECOG performance status (p=0.000) and GPA(3.5-4.0,p=0.005).Conclusions:There was no statistical difference between CK and NS for SBM from NSCLC in OS, LC and IC. However, CK is less invasive and may be more acceptable for patients. The result needs randomized trials to confirm and further study.