Short-course whole-brain radiotherapy (WBRT) for brain metastases due to small-cell lung cancer (SCLC)

Guenther Bohlen, Thekla Meyners, Susanne Kieckebusch, Radka Lohynska, Theo Veninga, Lukas J. A. Stalpers, Steven E. Schild, Dirk Rades

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Abstract

Many patients with brain metastases due to SCLC have a poor survival prognosis. The most common treatment is whole-brain radiotherapy (WBRT). This retrospective study compares short-course WBRT with 5x4Gy in 1 week to standard WBRT with 10x3Gy in 2 weeks. Forty-four SCLC patients receiving WBRT with 5x4Gy were compared to 102 patients receiving 10x3Gy for survival (OS) and local (intracerebral) control (LC). Seven further potential prognostic factors were investigated: age, gender, Karnofsky Performance Score (KPS), number of brain metastases, extracerebral metastases, interval from tumor diagnosis to WBRT, RPA (Recursive Partitioning Analysis) class. After 5x4Gy, 12-month OS was 15%, versus 22% after 10x3Gy (p=0.69). On multivariate analysis, improved OS was associated with age <or=60 years (p=0.013), KPS >or=70 (p <0.001), <4 brain metastases (p=0.011), and RPA class 1 (p <0.001). 12-month LC was 34% after 5x4Gy versus 25% after 10x3Gy (p=0.32). On multivariate analysis, improved LC was associated with KPS >or=70 (p <0.001), <4 brain metastases (p=0.027), and RPA class 1 (p <0.001). In patients with brain metastases due to SCLC, short-course WBRT with 5x4Gy provided similar outcomes as 10x3Gy and appears preferable, particularly for patients with poor estimated survival
Original languageEnglish
Pages (from-to)183-187
JournalClinical neurology and neurosurgery
Volume112
Issue number3
DOIs
Publication statusPublished - 2010

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