Two radiation regimens and prognostic factors for brain metastases in nonsmall cell lung cancer patients

Dirk Rades, Steven E. Schild, Radka Lohynska, Theo Veninga, Lukas J.A. Stalpers, Juergen Dunst

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

BACKGROUND. Nonsmall cell lung cancer (NSCLC) patients with brain metastases usually receive whole-brain radiotherapy (WBRT). Most of these patients survive for only a few months. A short course of WBRT would be preferable to longer regimens if it could provide similar survival. This retrospective study of NSCLC patients compared longer treatment programs with short-course WBRT with 5 x 4 Gy given during 5 days. METHODS. Data from 404 NSCLC patients treated with WBRT for brain metastases were retrospectively analyzed. The 140 patients who received 5 x 4 Gy given in 5 days were compared for survival with 264 patients who received either 10 x 3 Gy given in 2 weeks or 20 x 2 Gy given in 4 weeks. Seven further potential prognostic factors were investigated for survival including age, sex, Karnofsky performance score (KPS), number of brain metastases, extracranial metastases, interval from tumor diagnosis to WBRT, and RPA (recursive partitioning analysis) class. RESULTS. The WBRT regimen was not associated with survival (P = .55). On multivariate analysis, age < 60 years (vs ≥60 years, P = .020), KPS ≥70 (vs KPS < 70, P < .001), interval from tumor diagnosis to WBRT > 12 months (vs ≤12 months, P = .007), no extracranial metastases (P < .001), and RPA class 1 (vs RPA class 2 vs RPA class 3, P = .007) were significantly associated with improved survival. CONCLUSIONS. Short-course WBRT with 5 x 4 Gy appeared preferable for most NSCLC patients, as it was associated with survival similar to longer WBRT programs, and the short course was less time consuming.

Original languageEnglish (US)
Pages (from-to)1077-1082
Number of pages6
JournalCancer
Volume110
Issue number5
DOIs
StatePublished - Sep 1 2007

Keywords

  • Brain metastases
  • Nonsmall cell lung cancer
  • Survival
  • Treatment time
  • Whole-brain radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Fingerprint Dive into the research topics of 'Two radiation regimens and prognostic factors for brain metastases in nonsmall cell lung cancer patients'. Together they form a unique fingerprint.

Cite this