A23187 br WORLD NEUROSURGERY e e
WORLD NEUROSURGERY -: e1-e10, - 2019 www.journals.elsevier.com/world-neurosurgery e5
e6 www.SCIENCEDIRECT.com
Table 3. Cox Proportional Hazards Regression of Factors Prognostic for Brain Relapse, Systemic Relapse, and All-Cause Mortality
All-Cause Mortality (Model
All-Cause Mortality (Model
2: Systemic Therapy Given
1: Systemic Therapy Given at
Before Systemic and Brain
Brain Relapse
Systemic Relapse
Any Time Before Death)
Relapse, If Either Occurred)
Overall Model Is
Overall Model Is
Overall Model Is Not
Overall Model Is
Statistically Significant
Statistically Significant
Statistically Significant
Statistically Significant
Factor
Hazard Ratio
P Value
Hazard Ratio
P Value
Hazard Ratio
P Value
Hazard Ratio
P Value
Karnofsky Performance Status
1.01
0.46
Cancer type
Breast carcinoma
Reference
Reference
Reference
Reference
Reference
Reference
Reference
Reference
Nonesmall-cell lung cancer (adenocarcinoma)
0.32
0.13
Nonesmall-cell lung cancer (squamous cell)
0.06
0.02
Presence of controlled extracranial metastases
0.75
0.59
Average A23187 metastasis volume
1.00
0.93
Systemic therapy before stereotactic radiosurgery
2.81
0.19
Systemic therapy after stereotactic radiosurgery
0.22
<0.01
Time between primary tumor diagnosis and brain
0.9997
0.01
metastasis diagnosis
OUTCOMESPATIENTONTHERAPYSYSTEMICSRS-POSTOFEFFECT
RTICLEARIGINALO
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Table 4. Cox Proportional Hazards Regression Model Assessing the Effect of BloodeBrain Barrier Permeability on Brain Relapse, Systemic Relapse, and All-Cause Mortality
All-Cause Mortality (Model 2:
Systemic Therapy Given Before
Systemic and Brain Relapse, If
Brain Relapse
Systemic Relapse
Either Occurred)
Overall Model Is Statistically
Overall Model Is Statistically
Overall Model Is Statistically
Significant (Likelihood Ratio Test,
Significant (Likelihood Ratio Test,
Significant (Likelihood Ratio Test,
Factor
Hazard Ratio
P Value
Hazard Ratio
P Value
Hazard Ratio
P Value
Cancer type
Breast carcinoma
Reference
Reference
Reference
Reference
Reference
Reference
metastasis diagnosis
Did not receive post-SRS systemic therapy
Reference
Reference
Reference
Reference
Reference
Reference
not cross bloodebrain barrier
crosses bloodebrain barrier
SRS, stereotactic radiosurgery.
TIMOUR AL-KHINDI ET AL.
OUTCOMESPATIENTONTHERAPYSYSTEMICSRS-POSTOFEFFECT
RTICLEARIGINALO
e8 www.SCIENCEDIRECT.com
WORLD NEUROSURGERY, https://doi.org/10.1016/j.wneu.2019.05.218
Table 5. Cox Proportional Hazards Regression Model Assessing the Effect of Systemic Therapy Type on Brain Relapse, Systemic Relapse, and All-Cause Mortality
All-Cause Mortality (Model 2:
Systemic Therapy Given Before
Systemic and Brain Relapse, If Either
Brain Relapse
Systemic Relapse
Occurred)
Overall Model Is Not Statistically
Overall Model Is Statistically
Overall Model Is Statistically
Significant (Likelihood Ratio Test,
Significant (Likelihood Ratio
Significant (Likelihood Ratio Test,
Factor
Hazard Ratio
P Value
Hazard Ratio
P Value
Hazard Ratio
P Value
Karnofsky Performance Status
1.01
0.77
Cancer type
Breast carcinoma
Reference
Reference
Reference
Reference
Reference
Reference
Nonesmall-cell lung cancer (adenocarcinoma)
0.54
0.42
Nonesmall-cell lung cancer (squamous cell)
0.14
0.12
Presence of controlled extracranial metastases
0.96
0.95
Average brain metastasis volume
1.00
0.95
Systemic therapy before stereotactic radiosurgery
1.95
0.42
Time between primary tumor diagnosis and brain
0.9998
0.03
metastasis diagnosis
Did not receive postestereotactic radiosurgery
Reference
Reference
Reference
Reference
Reference
Reference
systemic therapy
Systemic therapy type
DNA damaging agent or DNA synthesis inhibitor
0.34
0.34
Hormone receptor antagonist
1.05
0.95
Microtubule antagonist
0.70
0.80
Angiogenesis inhibitor
Cannot assess
Cannot assess
<0.01
0.99
Cannot assess
Cannot assess
TIMOUR AL-KHINDI ET AL.
OUTCOMESPATIENTONTHERAPYSYSTEMICSRS-POSTOFEFFECT
RTICLEARIGINALO
ORIGINAL ARTICLE
TIMOUR AL-KHINDI ET AL. EFFECT OF POST-SRS SYSTEMIC THERAPY ON PATIENT OUTCOMES