Heisterkamp, C.

Kueter, J.D.

Meyners, T.

Rades, D.

Schild, S.E.

Stalpers, L.J.A.

Veninga, T.

English

Background: This study investigated potential prognostic factors in patients treated with whole-brain irradiation (WBI) alone for brain metastases from relatively radioresistant tumors such as malignant melanoma, renal cell carcinoma, and colorectal cancer. Additionally, a potential benefit from escalating the radiation dose was investigated. Methods: Data from 220 patients were retrospectively analyzed for overall survival and local control. Nine potential prognostic factors were evaluated: tumor type, WBI schedule, age, gender, Karnofsky performance score, number of brain metastases, extracerebral metastases, interval from diagnosis of cancer to WBI, and recursive partitioning analysis (RPA) class. Results: Survival rates at 6 and 12 months were 32% and 19%, respectively. In the multivariate analysis, WBI doses &gt; 30 Gy (p = 0.038), KPS &gt;= 70 (p &lt; 0.001), only 1-3 brain metastases (p = 0.007), no extracerebral metastases (p &lt; 0.001), and RPA class 1 (p &lt; 0.001) were associated with improved survival. Local control rates at 6 and 12 months were 37% and 15%, respectively. In the multivariate analyses, KPS &gt;= 70 (p &lt; 0.001), only 1-3 brain metastases (p &lt; 0.001), and RPA class 1 (p &lt; 0.001) were associated with improved local control. In RPA class 3 patients, survival rates at 6 months were 10% (35 of 39 patients) after 10 x 3 Gy and 9% (2 of 23 patients) after greater doses, respectively (p = 0.98). Conclusions: Improved outcomes were associated with WBI doses &gt; 30 Gy, better performance status, fewer brain metastases, lack of extracerebral metastases, and lower RPA class. Patients receiving WBI alone appear to benefit from WBI doses &gt; 30 Gy. However, such a benefit is limited to RPA class 1 or 2 patient

International Migration, Integration and Social Cohesion online publications

Prognostic factors for outcomes after whole-brain irradiation of brain metastases from relatively radioresistant tumors: a retrospective analysis

https://pure.uva.nl/ws/files/1463073/97093_340738.pdf

Prognostic factors for outcomes after whole-brain irradiation of brain metastases from relatively radioresistant tumors: a retrospective analysis

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International Migration, Integration and Social Cohesion online publications