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Treatment of Single or Multiple Brain Metastases by Hypofractionated Stereotactic Radiotherapy Using Helical Tomotherapy
Int. J. Mol. Sci. 2014, 15(5), 7554-7562; doi:10.3390/ijms15057554
Article

3D Radiation Therapy Boost Improves the Outcome of Whole Brain Radiation Therapy Treated RPA II Patients with One or Two Brain Metastases

1,* , 1
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1
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1
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2
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1 Radiotherapy Department, Centre de Lutte Contre le Cancer Paul Strauss, 3, rue de la Porte de L'Hôpital, 67065 Strasbourg Cedex, France 2 Laboratory of Biostatistics, Faculté de Médecine, 4, rue Kirschleger, 67085 Strasbourg Cedex, France
* Author to whom correspondence should be addressed.
Received: 6 February 2014 / Revised: 7 April 2014 / Accepted: 24 April 2014 / Published: 2 May 2014
(This article belongs to the Special Issue Brain Metastasis 2014)
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Abstract

Purpose: to evaluate the role of whole brain radiotherapy (WBRT) and radiation boost (RB) for 208 patients recursive partitioning analysis (RPA) II with 1 or 2 brain metastases (BM) at a single institution. Methods and Materials: the dose of WBRT was 30 Gy (10 fractions of 3 Gy). One hundred thirty-two patients (63.5%) benefited from RB of 9 Gy in 3 fractions of 3 Gy at the metastatic site. Patients had 1 or 2 BM in 122 (58.7%) and 86 cases (41.3%), respectively. Results: patients with one or two metastases had similar survival (4.6 and 5.1 months, respectively) (p = 0.4). Median overall survival (OS) for patients treated with WBRT and RB, and with WBRT alone was 5.9 and 3.7 months, respectively (p = 0.03). The 6-, 12- and 24-month OS rates after WBRT and RB were 48.5%, 25% and 10.6%, respectively, while WBRT alone resulted in OS rates of 34%, 22.4% and 3.2%, respectively (p = 0.03). After WBRT and RB, the 6-, 12- and 24-month local control rates were 92%, 82% and 67%, respectively, while they were 81.2%, 75% and 37.5%, respectively, after WBRT alone (p = 0.03). The 6-, 12- and 24-month brain control rates after WBRT and RB were 88.7%, 75.8% and 62%, respectively, and after WBRT alone they were 78.5%, 59% and 37.7%, respectively (p = 0.03). Conclusion: additional boost delivered with 3D conformal radiotherapy improves local and brain control rates significantly as well as overall survival for RPA II patients with 1 or 2 unresectable BM.
Keywords: brain metastases; whole brain radiotherapy; radiation boost brain metastases; whole brain radiotherapy; radiation boost
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).
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Antoni, D.; Clavier, J.-B.; Pop, M.; Schumacher, C.; Lefebvre, F.; Noël, G. 3D Radiation Therapy Boost Improves the Outcome of Whole Brain Radiation Therapy Treated RPA II Patients with One or Two Brain Metastases. Int. J. Mol. Sci. 2014, 15, 7554-7562.

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