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Int J Mol Sci. 2014 May 2;15(5):7554-62. doi: 10.3390/ijms15057554.

3D radiation therapy boost improves the outcome of whole brain radiation therapy treated RPA II patients with one or two brain metastases.

Author information

  • 1Radiotherapy Department, Centre de Lutte Contre le Cancer Paul Strauss, 3, rue de la Porte de L'Hôpital, 67065 Strasbourg Cedex, France. DAntoni@strasbourg.unicancer.fr.
  • 2Radiotherapy Department, Centre de Lutte Contre le Cancer Paul Strauss, 3, rue de la Porte de L'Hôpital, 67065 Strasbourg Cedex, France. JClavier@strasbourg.unicancer.fr.
  • 3Radiotherapy Department, Centre de Lutte Contre le Cancer Paul Strauss, 3, rue de la Porte de L'Hôpital, 67065 Strasbourg Cedex, France. MPop@strasbourg.unicancer.fr.
  • 4Radiotherapy Department, Centre de Lutte Contre le Cancer Paul Strauss, 3, rue de la Porte de L'Hôpital, 67065 Strasbourg Cedex, France. CSchumacher@strasbourg.unicancer.fr.
  • 5Laboratory of Biostatistics, Faculté de Médecine, 4, rue Kirschleger, 67085 Strasbourg Cedex, France. Francois.lefebvre@chru-strasbourg.fr.
  • 6Radiotherapy Department, Centre de Lutte Contre le Cancer Paul Strauss, 3, rue de la Porte de L'Hôpital, 67065 Strasbourg Cedex, France. GNoel@strasbourg.unicancer.fr.

Abstract

PURPOSE:

to evaluate the role of whole brain radiotherapy (WBRT) and radiation boost (RB) for 208 patients recursive partitioning analysis (RPA) II with 1 or 2 brain metastases (BM) at a single institution.

METHODS AND MATERIALS:

the dose of WBRT was 30 Gy (10 fractions of 3 Gy). One hundred thirty-two patients (63.5%) benefited from RB of 9 Gy in 3 fractions of 3 Gy at the metastatic site. Patients had 1 or 2 BM in 122 (58.7%) and 86 cases (41.3%), respectively.

RESULTS:

patients with one or two metastases had similar survival (4.6 and 5.1 months, respectively) (p = 0.4). Median overall survival (OS) for patients treated with WBRT and RB, and with WBRT alone was 5.9 and 3.7 months, respectively (p = 0.03). The 6-, 12- and 24-month OS rates after WBRT and RB were 48.5%, 25% and 10.6%, respectively, while WBRT alone resulted in OS rates of 34%, 22.4% and 3.2%, respectively (p = 0.03). After WBRT and RB, the 6-, 12- and 24-month local control rates were 92%, 82% and 67%, respectively, while they were 81.2%, 75% and 37.5%, respectively, after WBRT alone (p = 0.03). The 6-, 12- and 24-month brain control rates after WBRT and RB were 88.7%, 75.8% and 62%, respectively, and after WBRT alone they were 78.5%, 59% and 37.7%, respectively (p = 0.03).

CONCLUSION:

additional boost delivered with 3D conformal radiotherapy improves local and brain control rates significantly as well as overall survival for RPA II patients with 1 or 2 unresectable BM.

PMID:
24798750
PMCID:
PMC4057690
DOI:
10.3390/ijms15057554
[PubMed - indexed for MEDLINE]
Free PMC Article
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