Impact of ATM Variants on Radionecrosis and Local Control after Stereotactic Radiosurgery for Non Small Cell Lung Cancer Brain Metastases

BackgroundGenetic variants affecting the radiation response protein Ataxia Telangiectasia Mutated (ATM) have been associated with increased side effects, but also improved local control after conventional therapy. However, it is unknown whether ATM affect rates of radionecrosis (RN) and intracranial progression (LIP) following stereotactic radiosurgery (SRS) for brain metastases.MethodsPatients undergoing an initial course SRS non small cell lung cancer (NSCLC) metastases at a single institution were retrospectively identified. Kaplan-Meier estimates Cox proportional hazards testing was performed based on variant status.Results541 patients completed metastasis secondary to NSCLC, which 260 molecular profiling. identified in 36 cases (13.8%). Among who profiling, RN incidence 4.9% (95% CI 1.6 – 8.2%) 6 months 9.9% 4.8 - 15.0%) 12 months. not significantly among variants, 5.3% 0.0 15.3%) both (P=0.46). For all genomic LIP 5.4% 2.4 8.4%) 9.8% (5.5 14.1%) A significant improvement detected 3.1% (0.0 9.1%) (P=0.26). While differences according type (pathologic or significance) did reach significance, no pathologic experienced LIP.ConclusionWe detect associations between status NSCLC metastases. The current dataset allows estimation patient cohort sizes needed power future investigations identify genetic that associate outcomes SRS.