Investigating the Relationship Between Radiotherapy Dose on the neurogenic niches and Overall Survival in NSCLC Brain Metastases
Cialdella, F.; Bruil, D.; van der Boog, A. T. J.; Nagtegaal, S. H. J.; de Vos, F. Y. F.; Verhoeff, J. J. C.; David, S.
Show abstract
BackgroundNon-small cell lung cancer (NSCLC), the most common type of lung cancer, often leads to brain metastases (BMs) with a poor prognosis. Radiotherapy is the main treatment for BMs, which despite decades of development, still results in radiation of healthy tissue. Neural stem cells (NSCs), crucial for the establishment and preservation of the nervous system, are sensitive to radiation, therefore radiation damage to NSCs may affect overall survival (OS). NSCs are primarily located in the subventricular zone (SVZ) and the subgranular zone (SGZ) within the hippocampus (HPC). Our study aims to evaluate the impact of radiotherapy dose on NSCs on OS in patients with BMs from NSCLC. MethodsWe have retrospectively included 138 NSCLC patients with BMs, irradiated at a single academic institute. NSC regions were delineated on the non-enhanced T1 MR images with CAT12 and SPM. The association between regional mean doses in the SVZ and HPC and OS was examined using a Cox regression model. Additionally, survival differences between lesion contact and no direct contact with SVZ and HPC were investigated with Kaplan-Meier (KM) analysis. FindingsMultivariable Cox regression of dose on the SVZ and HPC showed a significant negative correlation, with a hazard ratio (HR) of 1.366 (p = 0.041 [95% (CI) 1.013- 1.842]) and 1.194 (p = 0.037 [95% CI 1.010 - 1.411]), respectively. KM analysis did not find a relationship between lesion contact with NSC-regions and OS. InterpretationRadiotherapy dose on the neurogenic niches is correlated with poorer OS and we found no association between direct lesion contact to NSC-regions and OS. We recommend further investigation into the impact of radiation on OS and neurocognitive function in a prospective study design in order to develop treatment approaches that minimize the potential harm to NSCs while maximizing effectiveness. FundingReceived no funds, grants, or support.
Matching journals
The top 2 journals account for 50% of the predicted probability mass.
Similar papers in this journal
- FLASH Radiotherapy Mitigates Radiation-Induced Lymphopenia and Prevents Immunosuppression via Chk1-STAT3 Axis Modulation in a Preclinical Thoracic Irradiation Model 96%
- Normal Tissue Complication Probability (NTCP) prediction model for osteoradionecrosis of the mandible in head and neck cancer patients following radiotherapy: Large-scale observational cohort 95%
- Contralateral Neck Recurrence Rates After Ipsilateral Neck Adjuvant Radiation in Head and Neck Carcinomas with a Pathologically Negative Contralateral Neck 95%
Similar papers in this journal
- LITE SABR M1: a Phase I Trial of Lattice Stereotactic Body Radiotherapy for Large Tumors 95%
- Dysphagia and shortness-of-breath as markers for treatment failure and survival in oropharyngeal cancer after radiation 94%
- Evaluation of indirect damage and damage saturation effects in dose-response curves of hypofractionated radiotherapy of early-stage NSCLC and brain metastases 94%
Similar papers in this journal
- Morphological changes after cranial fractionated photon radiotherapy: localized loss of white matter and grey matter volume with increasing dose 96%
- Detection of Alteration in Carotid Artery Volumetry Using Standard-of-care Computed Tomography Surveillance Scans Following Unilateral Radiation Therapy for Early-stage Tonsillar Squamous Cell Carcinoma Survivors: A Cross-Sectional Internally-Matched Carotid Isodose Analysis 95%
- Dose-dependent volume loss in subcortical deep grey matter structures after cranial radiotherapy 94%
Similar papers in this journal
- Avasopasem Manganese acts as both a Radioprotector and a Radiomitigator of Radiation-Induced Acute or Late Effects. 93%
- Leveraging intelligent optimization for automated, cardiac-sparing accelerated partial breast treatment planning 93%
- mTOR inhibitors as radiosensitizers in neuroendocrine neoplasms 91%
Similar papers in this journal
- Quality of life and patient-reported outcomes following proton therapy for oropharyngeal carcinoma: a systematic review 94%
- Effectiveness of FLASH vs conventional dose rate radiotherapy in a model of orthotopic, murine breast cancer 93%
- Standardising Breast Radiotherapy Structure Naming Conventions: A Machine Learning Approach 91%
"Similar papers" are the closest papers from that journal in the model's embedding space. They show what the match is built on, but the ranking comes mostly from a classifier over the whole training set, not from these examples alone.