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Does Time between Imaging Diagnosis and Initiation of Radiotherapy Impact Survival after Whole-Brain Radiotherapy for Brain Metastases?

By Carsten Nieder, Oddvar Spanne, Elinor Haukland and Astrid Dalhaug


Aims. To evaluate whether reduced waiting time influences survival of patients treated with whole-brain radiotherapy (WBRT) for brainmetastases. Materials and Methods. Retrospective intention-to-treat study including 110 patients treated with primary WBRT (typically 10 fractions of 3Gy; no other treatment between diagnosis and WBRT). Uni- and multivariate tests were performed. Results. Median delay between imaging diagnosis and WBRT was 12 days (range 0–66 days).WBRT started within 1 week in 36%, during the second week in 28%, and during the third week in 18% of patients. No significant correlation between waiting time and survival was evident, except for one subgroup of patients. Those without extracranial metastases (potentially more threatened by worse intracranial disease control) survived for a median of 2.5 months from WBRT if waiting time was 2 weeks or longer as compared to 5.6 months if waiting time was shorter than 2 weeks (� = 0.03). The same correlation was seen if survival was computed from imaging diagnosis. Conclusion. If departmental resources are not sufficient to provide immediate WBRT within 2 weeks to all patients, those without extracranial metastases should be prioritised.This study did not address the impact of waiting time on quality of life or symptom palliation

Topics: VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Radiology and diagnostic imaging: 763, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Radiologi og bildediagnostikk: 763
Publisher: Hindawi Publishing Corporation
Year: 2013
DOI identifier: 10.1155/2013
OAI identifier:

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