TY - JOUR
T1 - Prognostic factors for outcomes after whole-brain irradiation of brain metastases from relatively radioresistant tumors: a retrospective analysis
AU - Meyners, T.
AU - Heisterkamp, C.
AU - Kueter, J.D.
AU - Veninga, T.
AU - Stalpers, L.J.A.
AU - Schild, S.E.
AU - Rades, D.
PY - 2010
Y1 - 2010
N2 - Background: This study investigated potential prognostic factors in patients treated with whole-brain irradiation (WBI) alone for brain metastases from relatively radioresistant tumors such as malignant melanoma, renal cell carcinoma, and colorectal cancer. Additionally, a potential benefit from escalating the radiation dose was investigated. Methods: Data from 220 patients were retrospectively analyzed for overall survival and local control. Nine potential prognostic factors were evaluated: tumor type, WBI schedule, age, gender, Karnofsky performance score, number of brain metastases, extracerebral metastases, interval from diagnosis of cancer to WBI, and recursive partitioning analysis (RPA) class. Results: Survival rates at 6 and 12 months were 32% and 19%, respectively. In the multivariate analysis, WBI doses > 30 Gy (p = 0.038), KPS >= 70 (p < 0.001), only 1-3 brain metastases (p = 0.007), no extracerebral metastases (p < 0.001), and RPA class 1 (p < 0.001) were associated with improved survival. Local control rates at 6 and 12 months were 37% and 15%, respectively. In the multivariate analyses, KPS >= 70 (p < 0.001), only 1-3 brain metastases (p < 0.001), and RPA class 1 (p < 0.001) were associated with improved local control. In RPA class 3 patients, survival rates at 6 months were 10% (35 of 39 patients) after 10 x 3 Gy and 9% (2 of 23 patients) after greater doses, respectively (p = 0.98). Conclusions: Improved outcomes were associated with WBI doses > 30 Gy, better performance status, fewer brain metastases, lack of extracerebral metastases, and lower RPA class. Patients receiving WBI alone appear to benefit from WBI doses > 30 Gy. However, such a benefit is limited to RPA class 1 or 2 patients
AB - Background: This study investigated potential prognostic factors in patients treated with whole-brain irradiation (WBI) alone for brain metastases from relatively radioresistant tumors such as malignant melanoma, renal cell carcinoma, and colorectal cancer. Additionally, a potential benefit from escalating the radiation dose was investigated. Methods: Data from 220 patients were retrospectively analyzed for overall survival and local control. Nine potential prognostic factors were evaluated: tumor type, WBI schedule, age, gender, Karnofsky performance score, number of brain metastases, extracerebral metastases, interval from diagnosis of cancer to WBI, and recursive partitioning analysis (RPA) class. Results: Survival rates at 6 and 12 months were 32% and 19%, respectively. In the multivariate analysis, WBI doses > 30 Gy (p = 0.038), KPS >= 70 (p < 0.001), only 1-3 brain metastases (p = 0.007), no extracerebral metastases (p < 0.001), and RPA class 1 (p < 0.001) were associated with improved survival. Local control rates at 6 and 12 months were 37% and 15%, respectively. In the multivariate analyses, KPS >= 70 (p < 0.001), only 1-3 brain metastases (p < 0.001), and RPA class 1 (p < 0.001) were associated with improved local control. In RPA class 3 patients, survival rates at 6 months were 10% (35 of 39 patients) after 10 x 3 Gy and 9% (2 of 23 patients) after greater doses, respectively (p = 0.98). Conclusions: Improved outcomes were associated with WBI doses > 30 Gy, better performance status, fewer brain metastases, lack of extracerebral metastases, and lower RPA class. Patients receiving WBI alone appear to benefit from WBI doses > 30 Gy. However, such a benefit is limited to RPA class 1 or 2 patients
U2 - https://doi.org/10.1186/1471-2407-10-582
DO - https://doi.org/10.1186/1471-2407-10-582
M3 - Article
C2 - 20977700
SN - 1471-2407
VL - 10
SP - 582
JO - BMC Cancer
JF - BMC Cancer
ER -