Short-course whole-brain radiotherapy (WBRT) for brain metastases due to small-cell lung cancer (SCLC)
Abstract
Objective
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 5
×
4
Gy in 1 week to standard WBRT with 10
×
3
Gy in 2 weeks.
Methods
Forty-four SCLC patients receiving WBRT with 5
×
4
Gy were compared to 102 patients receiving 10
×
3
Gy 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.
Results
After 5
×
4
Gy, 12-month OS was 15%, versus 22% after 10
×
3
Gy (p
=
0.69). On multivariate analysis, improved OS was associated with age ≤60 years (p
=
0.013), KPS ≥70 (p
<
0.001), <4 brain metastases (p
=
0.011), and RPA class 1 (p
<
0.001). 12-month LC was 34% after 5
×
4
Gy versus 25% after 10
×
3
Gy (p
=
0.32). On multivariate analysis, improved LC was associated with KPS ≥70 (p
<
0.001), <4 brain metastases (p
=
0.027), and RPA class 1 (p
<
0.001).
Conclusion
In patients with brain metastases due to SCLC, short-course WBRT with 5
×
4
Gy provided similar outcomes as 10
×
3
Gy and appears preferable, particularly for patients with poor estimated survival.
Keywords: Brain metastases, Small-cell lung cancer, Palliative treatment, Whole-brain radiotherapy, Overall survival, Local control
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PII: S0303-8467(09)00301-1
doi:10.1016/j.clineuro.2009.11.004
© 2009 Elsevier B.V. All rights reserved.
