Dirk Rades1, Lena Sehmisch2, Amira Bajrovic3, Stefan Janssen2,4, Steven E Schild5. 1. Department of Radiation Oncology, University of Lübeck, Lübeck, Germany rades.dirk@gmx.net. 2. Department of Radiation Oncology, University of Lübeck, Lübeck, Germany. 3. Department of Radiation Oncology, University Medical Center Epppendorf, Hamburg, Germany. 4. Medical Practice for Radiotherapy and Radiation Oncology, Hannover, Germany. 5. Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A.
Abstract
BACKGROUND/AIM: Most patients with multiple brain metastases from melanoma receive whole-brain irradiation. In a previous study, doses >30 Gy resulted in better outcomes than 10×3 Gy. However, the optimal dose-fractionation regimen has not yet been defined. This study compared 20×2 Gy over four weeks, which was used in the previous study, to 12×3 Gy over two-and-a-half weeks. PATIENTS AND METHODS: Eleven patients treated with 20×2 Gy for multiple brain metastases were compared to 12 patients treated with 12×3 Gy. RESULTS: Intracerebral control rates at 6 and 12 months were 17% and 0% after 20×2 Gy vs. 42% and 11% after 12×3 Gy (p=0.28). Survival rates at 6 and 12 months were 36% and 9% after 20×2 Gy vs. 50% and 25% after 12×3 Gy (p=0.75). CONCLUSION: The less time-consuming regimen 12x3 Gy appeared not inferior to 20×2 Gy and a reasonable treatment option, particularly for patients with a limited life expectancy.
BACKGROUND/AIM: Most patients with multiple brain metastases from melanoma receive whole-brain irradiation. In a previous study, doses >30 Gy resulted in better outcomes than 10×3 Gy. However, the optimal dose-fractionation regimen has not yet been defined. This study compared 20×2 Gy over four weeks, which was used in the previous study, to 12×3 Gy over two-and-a-half weeks. PATIENTS AND METHODS: Eleven patients treated with 20×2 Gy for multiple brain metastases were compared to 12 patients treated with 12×3 Gy. RESULTS: Intracerebral control rates at 6 and 12 months were 17% and 0% after 20×2 Gy vs. 42% and 11% after 12×3 Gy (p=0.28). Survival rates at 6 and 12 months were 36% and 9% after 20×2 Gy vs. 50% and 25% after 12×3 Gy (p=0.75). CONCLUSION: The less time-consuming regimen 12x3 Gy appeared not inferior to 20×2 Gy and a reasonable treatment option, particularly for patients with a limited life expectancy.
Authors: Dirk Rades; Oliver Blanck; Mai Trong Khoa; Pham VAN Thai; Nguyen Quang Hung; Liesa Dziggel; Steven E Schild Journal: In Vivo Date: 2018 Mar-Apr Impact factor: 2.155