C Nieder1, M Niewald, K Schnabel. 1. Abteilung für Strahlentherapie, Radiologische Universitätsklinik, Universität des Saarlandes.
Abstract
BACKGROUND: To evaluate which patients older than 70 years will benefit by radiotherapy for their brain metastases. PATIENTS AND METHODS: The data of 35 patients in this age-group who were treated between 1983 and 1994 were retrospectively analyzed. All patients were previously untreated and received a whole-brain irradiation and concomitantly corticosteroids. The median total dose was 30 Gy (fractionation: 10 times 3 Gy in 2 weeks). Six patients each received lower or higher total doses with 50.4 Gy at maximum. RESULTS: Six patients failed to complete their prescribed treatment (17%). The median survival of all patients who completed their radiotherapy course was 67 days only. Patients with extracerebral metastases had a median survival of 31 days. Survival was not dependent on total dose of radiotherapy. In 56% of all cases the general condition of the patients improved or remained stable at a high level. Karnofsky-performance status was the most important prognostic factor. CONCLUSIONS: Advanced age is an unfavourable prognostic factor. Only patients in good general condition without extracerebral metastases had survival times which justify radiotherapy for their brain metastases. It seems to be extremely doubtful whether the other cases surviving 1 to 2 months should undergo radiotherapy. In each case a short and easily tolerable course of radiotherapy should be preferred.
BACKGROUND: To evaluate which patients older than 70 years will benefit by radiotherapy for their brain metastases. PATIENTS AND METHODS: The data of 35 patients in this age-group who were treated between 1983 and 1994 were retrospectively analyzed. All patients were previously untreated and received a whole-brain irradiation and concomitantly corticosteroids. The median total dose was 30 Gy (fractionation: 10 times 3 Gy in 2 weeks). Six patients each received lower or higher total doses with 50.4 Gy at maximum. RESULTS: Six patients failed to complete their prescribed treatment (17%). The median survival of all patients who completed their radiotherapy course was 67 days only. Patients with extracerebral metastases had a median survival of 31 days. Survival was not dependent on total dose of radiotherapy. In 56% of all cases the general condition of the patients improved or remained stable at a high level. Karnofsky-performance status was the most important prognostic factor. CONCLUSIONS: Advanced age is an unfavourable prognostic factor. Only patients in good general condition without extracerebral metastases had survival times which justify radiotherapy for their brain metastases. It seems to be extremely doubtful whether the other cases surviving 1 to 2 months should undergo radiotherapy. In each case a short and easily tolerable course of radiotherapy should be preferred.
Authors: Julien Dinkel; Christian Thieke; Christian Plathow; Patrick Zamecnik; Hermann Prüm; Peter E Huber; Hans-Ulrich Kauczor; Heinz-Peter Schlemmer; Christian M Zechmann Journal: Strahlenther Onkol Date: 2011-06-27 Impact factor: 3.621