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

Research output: Contribution to journalArticle

7 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 languageEnglish (US)
Pages (from-to)183-187
Number of pages5
JournalClinical Neurology and Neurosurgery
Volume112
Issue number3
DOIs
StatePublished - Apr 2010

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Small Cell Lung Carcinoma
Radiotherapy
Neoplasm Metastasis
Brain
Survival
Multivariate Analysis
Retrospective Studies

Keywords

  • Brain metastases
  • Local control
  • Overall survival
  • Palliative treatment
  • Small-cell lung cancer
  • Whole-brain radiotherapy

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Bohlen, G., Meyners, T., Kieckebusch, S., Lohynska, R., Veninga, T., Stalpers, L. J. A., ... Rades, D. (2010). Short-course whole-brain radiotherapy (WBRT) for brain metastases due to small-cell lung cancer (SCLC). Clinical Neurology and Neurosurgery, 112(3), 183-187. https://doi.org/10.1016/j.clineuro.2009.11.004

Short-course whole-brain radiotherapy (WBRT) for brain metastases due to small-cell lung cancer (SCLC). / Bohlen, Guenther; Meyners, Thekla; Kieckebusch, Susanne; Lohynska, Radka; Veninga, Theo; Stalpers, Lukas J A; Schild, Steven E.; Rades, Dirk.

In: Clinical Neurology and Neurosurgery, Vol. 112, No. 3, 04.2010, p. 183-187.

Research output: Contribution to journalArticle

Bohlen, G, Meyners, T, Kieckebusch, S, Lohynska, R, Veninga, T, Stalpers, LJA, Schild, SE & Rades, D 2010, 'Short-course whole-brain radiotherapy (WBRT) for brain metastases due to small-cell lung cancer (SCLC)', Clinical Neurology and Neurosurgery, vol. 112, no. 3, pp. 183-187. https://doi.org/10.1016/j.clineuro.2009.11.004
Bohlen, Guenther ; Meyners, Thekla ; Kieckebusch, Susanne ; Lohynska, Radka ; Veninga, Theo ; Stalpers, Lukas J A ; Schild, Steven E. ; Rades, Dirk. / Short-course whole-brain radiotherapy (WBRT) for brain metastases due to small-cell lung cancer (SCLC). In: Clinical Neurology and Neurosurgery. 2010 ; Vol. 112, No. 3. pp. 183-187.
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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.",
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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

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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.

KW - Brain metastases

KW - Local control

KW - Overall survival

KW - Palliative treatment

KW - Small-cell lung cancer

KW - Whole-brain radiotherapy

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