Short-course whole-brain radiotherapy (WBRT) for brain metastases due to small-cell lung cancer (SCLC)

Guenther Bohlen; Thekla Meyners; Susanne Kieckebusch; Radka Lohynska; Theo Veninga; Lukas J.A. Stalpers; Steven E. Schild; Dirk Rades

doi:10.1016/j.clineuro.2009.11.004

Short-course whole-brain radiotherapy (WBRT) for brain metastases due to small-cell lung cancer (SCLC)

Guenther Bohlen, Thekla Meyners, Susanne Kieckebusch, Radka Lohynska, Theo Veninga, Lukas J.A. Stalpers, Steven E. Schild, Dirk Rades^*

^*Corresponding author for this work

Department of Radiotherapy

12 Citations (Scopus)

Abstract

Objective: Many patients with brain metastases due to SCLC have a poor survival prognosis. The most common treatment is whole-brain radiotherapy (WBRT). This retrospective study compares short-course WBRT with 5 × 4 Gy in 1 week to standard WBRT with 10 × 3 Gy in 2 weeks. Methods: Forty-four SCLC patients receiving WBRT with 5 × 4 Gy were compared to 102 patients receiving 10 × 3 Gy for survival (OS) and local (intracerebral) control (LC). Seven further potential prognostic factors were investigated: age, gender, Karnofsky Performance Score (KPS), number of brain metastases, extracerebral metastases, interval from tumor diagnosis to WBRT, RPA (Recursive Partitioning Analysis) class. Results: After 5 × 4 Gy, 12-month OS was 15%, versus 22% after 10 × 3 Gy (p = 0.69). On multivariate analysis, improved OS was associated with age ≤60 years (p = 0.013), KPS ≥70 (p < 0.001), <4 brain metastases (p = 0.011), and RPA class 1 (p < 0.001). 12-month LC was 34% after 5 × 4 Gy versus 25% after 10 × 3 Gy (p = 0.32). On multivariate analysis, improved LC was associated with KPS ≥70 (p < 0.001), <4 brain metastases (p = 0.027), and RPA class 1 (p < 0.001). Conclusion: In patients with brain metastases due to SCLC, short-course WBRT with 5 × 4 Gy provided similar outcomes as 10 × 3 Gy and appears preferable, particularly for patients with poor estimated survival.

Original language	English
Journal	Clinical Neurology and Neurosurgery
Volume	112
Issue number	3
Pages (from-to)	183-187
Number of pages	5
ISSN	0303-8467
DOIs	https://doi.org/10.1016/j.clineuro.2009.11.004
Publication status	Published - 01.04.2010

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10.1016/j.clineuro.2009.11.004

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@article{3d17a439bf664ab4894e72020f0adde9,

title = "Short-course whole-brain radiotherapy (WBRT) for brain metastases due to small-cell lung cancer (SCLC)",

abstract = "Objective: Many patients with brain metastases due to SCLC have a poor survival prognosis. The most common treatment is whole-brain radiotherapy (WBRT). This retrospective study compares short-course WBRT with 5 × 4 Gy in 1 week to standard WBRT with 10 × 3 Gy in 2 weeks. Methods: Forty-four SCLC patients receiving WBRT with 5 × 4 Gy were compared to 102 patients receiving 10 × 3 Gy for survival (OS) and local (intracerebral) control (LC). Seven further potential prognostic factors were investigated: age, gender, Karnofsky Performance Score (KPS), number of brain metastases, extracerebral metastases, interval from tumor diagnosis to WBRT, RPA (Recursive Partitioning Analysis) class. Results: After 5 × 4 Gy, 12-month OS was 15\%, versus 22\% after 10 × 3 Gy (p = 0.69). On multivariate analysis, improved OS was associated with age ≤60 years (p = 0.013), KPS ≥70 (p < 0.001), <4 brain metastases (p = 0.011), and RPA class 1 (p < 0.001). 12-month LC was 34\% after 5 × 4 Gy versus 25\% after 10 × 3 Gy (p = 0.32). On multivariate analysis, improved LC was associated with KPS ≥70 (p < 0.001), <4 brain metastases (p = 0.027), and RPA class 1 (p < 0.001). Conclusion: In patients with brain metastases due to SCLC, short-course WBRT with 5 × 4 Gy provided similar outcomes as 10 × 3 Gy and appears preferable, particularly for patients with poor estimated survival.",

author = "Guenther Bohlen and Thekla Meyners and Susanne Kieckebusch and Radka Lohynska and Theo Veninga and Stalpers, \{Lukas J.A.\} and Schild, \{Steven E.\} and Dirk Rades",

year = "2010",

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day = "1",

doi = "10.1016/j.clineuro.2009.11.004",

language = "English",

volume = "112",

pages = "183--187",

journal = "Clinical Neurology and Neurosurgery",

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TY - JOUR

T1 - Short-course whole-brain radiotherapy (WBRT) for brain metastases due to small-cell lung cancer (SCLC)

AU - Bohlen, Guenther

AU - Meyners, Thekla

AU - Kieckebusch, Susanne

AU - Lohynska, Radka

AU - Veninga, Theo

AU - Stalpers, Lukas J.A.

AU - Schild, Steven E.

AU - Rades, Dirk

PY - 2010/4/1

Y1 - 2010/4/1

N2 - Objective: Many patients with brain metastases due to SCLC have a poor survival prognosis. The most common treatment is whole-brain radiotherapy (WBRT). This retrospective study compares short-course WBRT with 5 × 4 Gy in 1 week to standard WBRT with 10 × 3 Gy in 2 weeks. Methods: Forty-four SCLC patients receiving WBRT with 5 × 4 Gy were compared to 102 patients receiving 10 × 3 Gy for survival (OS) and local (intracerebral) control (LC). Seven further potential prognostic factors were investigated: age, gender, Karnofsky Performance Score (KPS), number of brain metastases, extracerebral metastases, interval from tumor diagnosis to WBRT, RPA (Recursive Partitioning Analysis) class. Results: After 5 × 4 Gy, 12-month OS was 15%, versus 22% after 10 × 3 Gy (p = 0.69). On multivariate analysis, improved OS was associated with age ≤60 years (p = 0.013), KPS ≥70 (p < 0.001), <4 brain metastases (p = 0.011), and RPA class 1 (p < 0.001). 12-month LC was 34% after 5 × 4 Gy versus 25% after 10 × 3 Gy (p = 0.32). On multivariate analysis, improved LC was associated with KPS ≥70 (p < 0.001), <4 brain metastases (p = 0.027), and RPA class 1 (p < 0.001). Conclusion: In patients with brain metastases due to SCLC, short-course WBRT with 5 × 4 Gy provided similar outcomes as 10 × 3 Gy and appears preferable, particularly for patients with poor estimated survival.

AB - Objective: Many patients with brain metastases due to SCLC have a poor survival prognosis. The most common treatment is whole-brain radiotherapy (WBRT). This retrospective study compares short-course WBRT with 5 × 4 Gy in 1 week to standard WBRT with 10 × 3 Gy in 2 weeks. Methods: Forty-four SCLC patients receiving WBRT with 5 × 4 Gy were compared to 102 patients receiving 10 × 3 Gy for survival (OS) and local (intracerebral) control (LC). Seven further potential prognostic factors were investigated: age, gender, Karnofsky Performance Score (KPS), number of brain metastases, extracerebral metastases, interval from tumor diagnosis to WBRT, RPA (Recursive Partitioning Analysis) class. Results: After 5 × 4 Gy, 12-month OS was 15%, versus 22% after 10 × 3 Gy (p = 0.69). On multivariate analysis, improved OS was associated with age ≤60 years (p = 0.013), KPS ≥70 (p < 0.001), <4 brain metastases (p = 0.011), and RPA class 1 (p < 0.001). 12-month LC was 34% after 5 × 4 Gy versus 25% after 10 × 3 Gy (p = 0.32). On multivariate analysis, improved LC was associated with KPS ≥70 (p < 0.001), <4 brain metastases (p = 0.027), and RPA class 1 (p < 0.001). Conclusion: In patients with brain metastases due to SCLC, short-course WBRT with 5 × 4 Gy provided similar outcomes as 10 × 3 Gy and appears preferable, particularly for patients with poor estimated survival.

UR - https://www.scopus.com/pages/publications/77249119642

U2 - 10.1016/j.clineuro.2009.11.004

DO - 10.1016/j.clineuro.2009.11.004

M3 - Journal articles

C2 - 19962229

AN - SCOPUS:77249119642

SN - 0303-8467

VL - 112

SP - 183

EP - 187

JO - Clinical Neurology and Neurosurgery

JF - Clinical Neurology and Neurosurgery

IS - 3

ER -

Short-course whole-brain radiotherapy (WBRT) for brain metastases due to small-cell lung cancer (SCLC)

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