Comparison of Stereotactic Radiosurgery and Whole Brain Radiotherapy in Patients with Four or More Brain Metastases.
10.3857/jkstro.2009.27.3.163
- Author:
Cheoljin KIM
1
;
Miyoung BAEK
;
Sungkwang PARK
;
Kijung AHN
;
Heunglae CHO
Author Information
1. Department of Radiation Oncology, Inje University College of Medicine, Busan, Korea. oncodoc@inje.ac.kr
- Publication Type:Original Article
- Keywords:
Multiple brain metastases;
Stereotactic radiosurgery;
Whole brain radiotherapy
- MeSH:
Brain;
Breast Neoplasms;
Carcinoma, Non-Small-Cell Lung;
Colorectal Neoplasms;
Disease-Free Survival;
Esophageal Neoplasms;
Follow-Up Studies;
Humans;
Lung Neoplasms;
Melanoma;
Neoplasm Metastasis;
Radiosurgery;
Retrospective Studies
- From:The Journal of the Korean Society for Therapeutic Radiology and Oncology
2009;27(3):163-168
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study was a retrospective evaluation of the efficacy of stereotactic radiosurgery (SRS) in patients with >4 metastases to the brain. MATERIALS AND METHODS: Between January 2004 and December 2006, 68 patients with > or = 4 multiple brain metastases were included and reviewed retrospectively. Twenty-nine patients received SRS and 39 patients received whole brain radiotherapy (WBRT). Patients with small cell lung cancers and melanomas were excluded. The primary lesions were non-small cell lung cancer (69.0%) and breast cancer (13.8%) in the SRS group and non-small cell lung cancer (64.1%), breast cancer (15.4%), colorectal cancer (12.8%), esophageal cancer (5.1%) in the WBRT group. SRS involved gamma-knife radiosurgery and delivered 10~20 Gy (median, 16 Gy) in a single fraction with a 50% marginal dose. WBRT was delivered daily in 3 Gy fractions, for a total of 30 Gy. After completion of treatment, a follow-up brain MRI or a contrast-enhanced brain CT was reviewed. The overall survival and intracranial progression-free survival were compared in each group. RESULTS: The median follow-up period was 5 months (range, 2~19 months) in the SRS group and 6 months (range, 4~23 months) in the WBRT group. The mean number of metastatic lesions in the SRS and WBRT groups was 6 and 5, respectively. The intracranial progression-free survival and overall survival in the SRS group was 5.1 and 5.6 months, respectively, in comparison to 6.1 and 7.2 months, respectively, in the WBRT group. CONCLUSION: SRS was less effective than WBRT in the treatment of patients with >4 metastases to the brain.
