Differential impact of whole-brain radiotherapy added to radiosurgery for brain metastases

International Journal of Radiation Oncology, Biology, Physics
Doo-Sik KongJong-Hyun Kim

Abstract

The authors investigated whether the addition of whole-brain radiotherapy (WBRT) to stereotactic radiosurgery (SRS) provided any therapeutic benefit according to recursive partitioning analysis (RPA) class. Two hundred forty-five patients with 1 to 10 metastases who underwent SRS between January 2002 and December 2007 were included in the study. Of those, 168 patients were treated with SRS alone and 77 patients received SRS followed by WBRT. Actuarial curves were estimated using the Kaplan-Meier method regarding overall survival (OS), distant brain control (DC), and local brain control (LC) stratified by RPA class. Analyses for known prognostic variables were performed using the Cox proportional hazards model. Univariate and multivariate analysis revealed that control of the primary tumor, small number of brain metastases, Karnofsky performance scale (KPS) > 70, and initial treatment modalities were significant predictors for survival. For RPA class 1, SRS plus WBRT was associated with a longer survival time compared with SRS alone (854 days vs. 426 days, p = 0.042). The SRS plus WBRT group also showed better LC rate than did the SRS-alone group (p = 0.021), although they did not show a better DC rate (p = 0.079). By contrast, ...Continue Reading

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Citations

Aug 24, 2011·Annals of Surgical Oncology·Xiang ZhangJinxiang Cheng
Jul 12, 2012·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·L GottwaldJ Chalubinska-Fendler
May 26, 2012·Cancer radiothérapie : journal de la Société française de radiothérapie oncologique·G NoëlF Thillays
Sep 7, 2014·Practical Radiation Oncology·Shaakir HasanRicardo J Komotar

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