Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2006 Jun 29:1:20.
doi: 10.1186/1748-717X-1-20.

Whole brain radiation therapy in management of brain metastasis: results and prognostic factors

Elisa Y Saito  1 , Gustavo A Viani, Robson Ferrigno, Ricardo A Nakamura, Paulo E Novaes, Cassio A Pellizzon, Ricardo C Fogaroli, Maria A Conte, Joao V Salvajoli
Affiliations

Whole brain radiation therapy in management of brain metastasis: results and prognostic factors

Elisa Y Saito et al. Radiat Oncol. .

Abstract

Purpose: To evaluate the prognostic factors associated with overall survival in patients with brain metastasis treated with whole brain radiotherapy (WBRT) and estimate the potential improvement in survival for patients with brain metastases, stratified by the Radiation Therapy Oncology Group (RTOG) recursive partitioning analysis (RPA) class.

Patients and methods: From January 1996 to December 2000, 270 medical records of patients with diagnosis of brain metastasis, who received WBRT in the Hospital do Cancer Sao Paulo A.C. Camargo in the period, were analyzed. The surgery followed by WBRT was used in 15% of patients and 85% of others patients were submitted at WBRT alone; in this cohort 134 patients (50%) received the fractionation schedule of 30 Gy in 10 fractions. The most common primary tumor type was breast (33%) followed by lung (29%), and solitary brain metastasis was present in 38.1% of patients. The prognostic factors evaluated for overall survival were: gender, age, Karnofsky Performance Status (KPS), number of lesions, localization of lesions, primary tumor site, surgery, chemotherapy, absence extracranial disease, RPA class and radiation doses and fractionation.

Results: The OS in 1, 2 and 3 years was 25.1%, 10.4% and 4.3% respectively, and the median survival time was 4.6 months. The median survival time in months according to RPA class after WBRT was: 6.2 class I, 4.2 class II and 3.0 class III (p < 0.0001). In univariate analysis, the significant prognostic factors associated with better survival were: KPS higher than 70 (p < 0.0001), neurosurgery (p < 0.0001) and solitary brain metastasis (p = 0.009). In multivariate analysis, KPS higher than 70 (p < 0.001) and neurosurgery (p = 0.001) maintained positively associated with the survival.

Conclusion: In this series, the patients with higher perform status, RPA class I, and treated with surgery followed by whole brain radiotherapy had better survival. This data suggest that patients with cancer and a single metastasis to the brain may be treated effectively with surgical resection plus radiotherapy. The different radiotherapy doses and fractionation schedules did not altered survival.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Overall Survival (Kaplan Meier).
Figure 2
Figure 2
Overall Survival by KPS (Log Rank).
Figure 3
Figure 3
Overall Survival by RPA CLASS (Log Rank).
Figure 4
Figure 4
Overall Survival by number of lesions (Log Rank).
Figure 5
Figure 5
Overall Survival by neurosurgery (Log Rank).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Wen PY, Black PM, Loeffler JS. Cancer: Principles and Practice of Oncology (ed 6) In: DeVita V, Hellman S, Rosenberg SA, editor. Metastatic Brain Cancer. Philadelphia, PA, Lippincott, WIlliams, & Wilkins; 2001. pp. 2655–2670.
    1. Zimm S, Wampler GL, Stablein D, et al. Intracerebral metastases in solid-tumor patients: Natural history and results of treatment. Cancer. 1981;48:384–394. doi: 10.1002/1097-0142(19810715)48:2<384::AID-CNCR2820480227>3.0.CO;2-8. - DOI - PubMed
    1. Sundstrom JT, Minn H, Lertola KK, et al. Prognosis of patients treated for intracranial metastase with whole-brain irradiation. Ann Med. 1998;30:296–299. - PubMed
    1. Chao JH, Phillips R, Nickson JJ. Roentgenraytherapy of cerebral metastases. Cancer. 1954;7:682–689. doi: 10.1002/1097-0142(195407)7:4<682::AID-CNCR2820070409>3.0.CO;2-S. - DOI - PubMed
    1. Gaspar L, Scott C, Rotman M, et al. Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys. 1997;37:745–754. doi: 10.1016/S0360-3016(96)00619-0. - DOI - PubMed