Outcomes after whole-brain radiotherapy for brain metastases with 5×4 gy: Importance of overall treatment time

Background/Aim: To investigate the impact of overall treatment time (OTT) of whole-brain radiotherapy (WBRT) with 5×4 Gy on outcomes. Patients and Methods: Forty-four patients for whom WBRT was started on a Monday (OTT=5 days) were compared to 136 patients, for whom WBRT was started on another weekday (OTT=7 days; weekend break) regarding intracerebral control and survival. Seven other factors were also analyzed. Results: Intracerebral control at 6 and 12 months was 64% and 36% after OTT of 5 days vs. 57% and 38% after OTT of 7 days (p=0.68). On multivariate analysis, intracerebral control was positively associated with a better Eastern Cooperative Oncology Group performance score (ECOG-PS) (p<0.001). Survival at 6 and 12 months was 36% and 16% after OTT of 5 days vs. 35% and 19% after OTT of 7 days (p=0.81). On multivariate analysis, survival was positively associated with better ECOG-PS (p<0.001) and absence of extracerebral lesions (p=0.004). Conclusion: Prolongation of OTT to 7 days had no impact on outcomes after WBRT with 5×4 Gy.