{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T21:42:03Z","timestamp":1769204523543,"version":"3.49.0"},"reference-count":27,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2001,3,1]]},"abstract":"<jats:p> PURPOSE: As therapy for locally advanced non\u2013small-cell lung carcinoma (NSCLC) improves, brain metastases (BM) may become a greater problem. We analyzed our chemoradiation experience for patients at highest risk for the brain as the first failure site. <\/jats:p><jats:p> METHODS: Records for 150 consecutive patients with stage II\/III NSCLC treated definitively with chemoradiation from June 1992 to June 1998 at the University of Pennsylvania were reviewed. Most patients (89%) received cisplatin, paclitaxel, or both. All had negative brain imaging before treatment. Posttreatment brain imaging was performed for suspicious symptoms. Incidence of BM was examined as a function of age, sex, histology, stage, performance status, weight loss, tumor location, surgery, radiation dose, initial radiation field, chemotherapy regimen, and chemotherapy timing. <\/jats:p><jats:p> RESULTS: Crude and 2-year actuarial rates of BM were 19% and 30%, respectively. Among pretreatment parameters, stage IIIB was associated with a higher risk of BM (P &lt; .04) versus stage II\/IIIA. Histology alone was not significant (P &lt; .12), although patients with IIIB nonsquamous tumors had an exceptionally high 2-year BM rate of 42% (P &lt; .01 v all others). Examining treatment-related parameters, crude and 2-year actuarial risk of BM were 27% and 39%, respectively, in patients receiving chemotherapy before radiotherapy and 15% and 20%, respectively, when radiotherapy was not delayed (P &lt; .05). On multivariate analysis, timing of chemotherapy (P &lt; .01) and stage IIIA versus IIIB (P &lt; .01) remained significant. <\/jats:p><jats:p> CONCLUSION: Patients with later stage, nonsquamous NSCLC, particularly those receiving induction chemotherapy, have sufficiently common BM rates to justify future trials including prophylactic cranial irradiation. <\/jats:p>","DOI":"10.1200\/jco.2001.19.5.1344","type":"journal-article","created":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T08:08:14Z","timestamp":1487923694000},"page":"1344-1349","source":"Crossref","is-referenced-by-count":136,"title":["Factors Affecting the Risk of Brain Metastases After Definitive Chemoradiation for Locally Advanced  Non\u2013Small-Cell Lung Carcinoma"],"prefix":"10.1200","volume":"19","author":[{"given":"Theodore J.","family":"Robnett","sequence":"first","affiliation":[{"name":"From the Department of Radiation Oncology and the Division of Medical Oncology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitchell","family":"Machtay","sequence":"additional","affiliation":[{"name":"From the Department of Radiation Oncology and the Division of Medical Oncology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James P.","family":"Stevenson","sequence":"additional","affiliation":[{"name":"From the Department of Radiation Oncology and the Division of Medical Oncology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth M.","family":"Algazy","sequence":"additional","affiliation":[{"name":"From the Department of Radiation Oncology and the Division of Medical Oncology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen M.","family":"Hahn","sequence":"additional","affiliation":[{"name":"From the Department of Radiation Oncology and the Division of Medical Oncology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"R1-085382","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/87.3.183"},{"key":"R2-085382","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(97)00135-4"},{"key":"R3-085382","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199908123410703"},{"key":"R4-085382","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199010043231403"},{"key":"R5-085382","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/87.3.198"},{"key":"R6-085382","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1996.14.4.1065"},{"key":"R7-085382","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.8.2996"},{"key":"R10-085382","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(99)00120-0"},{"key":"R11-085382","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(97)00251-4"},{"key":"R12-085382","doi-asserted-by":"publisher","DOI":"10.1002\/jso.2930400413"},{"key":"R13-085382","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.9.2700"},{"key":"R14-085382","unstructured":"Cox  JD,   Yesner  R,   Mietlowski  W,  et al:  Adenocarcinoma of the lung:   Recent results from the veterans administration lung group.   Am Rev Respir Dis 120:  1025,1979-1029,"},{"key":"R15-085382","doi-asserted-by":"publisher","DOI":"10.1016\/0007-0971(71)90032-5"},{"key":"R16-085382","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(98)00429-5"},{"key":"R17-085382","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(80)90195-9"},{"key":"R18-085382","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(81)90005-5"},{"key":"R19-085382","doi-asserted-by":"crossref","unstructured":"Mandel  L,   Hilaris  B,   Sullivan  M,  et al:  The treatment of single brain metastasis from non-oat cell lung carcinoma:   Surgery and radiation versus radiation therapy alone.   Cancer 58:  641,1986-649,","DOI":"10.1002\/1097-0142(19860801)58:3<641::AID-CNCR2820580308>3.0.CO;2-4"},{"key":"R20-085382","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197206)29:6<1477::AID-CNCR2820290610>3.0.CO;2-H"},{"key":"R21-085382","doi-asserted-by":"crossref","unstructured":"Law  A,   Daly  BMM:   High incidence of isolated brain metastases (CNSMets) following complete response (CR) in advanced non-small cell lung cancer (NSCLC):   A new challenge.   Lung Cancer 18:  65,1997  (abstr 248)","DOI":"10.1016\/S0169-5002(97)89628-6"},{"key":"R22-085382","doi-asserted-by":"crossref","unstructured":"Eberhardt  W,   Wilke  H,   Stuschke  M,  et al:  Preoperative chemotherapy and chemoradiotherapy based on hyperfractionated accelerated radiotherapy followed by surgery in locally advanced (LAD) inoperable NSCLC stages IIIA and IIIB:   The value of PCI.   Lung Cancer 18:  65,1997  (abstr 249)","DOI":"10.1016\/S0169-5002(97)89631-6"},{"key":"R23-085382","unstructured":"Miller  TP,   Crowley  JJ,   Mira  J,  et al:  A randomized trial of chemotherapy and radiotherapy for stage III non-small cell lung cancer.   Cancer Therapeutics 1:  229,1998-236,"},{"key":"R24-085382","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1981.03310300023013"},{"key":"R25-085382","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(91)90681-S"},{"key":"R26-085382","doi-asserted-by":"publisher","DOI":"10.1007\/BF00253278"},{"key":"R27-085382","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1993.11.2.336"},{"key":"R28-085382","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.9.2692"},{"key":"R29-085382","doi-asserted-by":"crossref","unstructured":"Komaki  R,   Seiferheld  W,   Curran  W,  et al:  Sequential vs. concurrent chemotherapy and radiation therapy for inoperable non-small cell lung cancer (NSCLC):   Analysis of failures in a phase III study (RTOG 9410).   Int J Radiat Oncol Biol Physics 48:  113,2000  (abstr 5)","DOI":"10.1016\/S0360-3016(00)80022-X"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.2001.19.5.1344","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T21:46:37Z","timestamp":1653515197000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.2001.19.5.1344"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,3,1]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2001,3,1]]}},"alternative-id":["10.1200\/JCO.2001.19.5.1344"],"URL":"https:\/\/doi.org\/10.1200\/jco.2001.19.5.1344","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,3,1]]}}}