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Randomized Controlled Trial
. 2014 May 20:9:116.
doi: 10.1186/1748-717X-9-116.

Management of brain metastases with stereotactic radiosurgery alone versus whole brain irradiation alone versus both

Mahmoud M El Gantery, Hoda M Abd El Baky  1 , Hesham A El Hossieny, Mohamed Mahmoud, Osama Youssef
Affiliations
Randomized Controlled Trial

Management of brain metastases with stereotactic radiosurgery alone versus whole brain irradiation alone versus both

Mahmoud M El Gantery et al. Radiat Oncol. .

Abstract

Introduction: This prospective randomized study aimed to evaluate the role of WBRT + SRS compared to SRS alone and to WBRT alone in improvement of overall survival, brain local control and neurologic manifestations.

Patients and methods: The trial included 60 patients with 1 to 3 brain metastases treated at the Radiotherapy Department, National Cancer Institute. 21 patients received WBRT + SRS, 18 patients received SRS alone and 21 patients received WBRT alone.

Results: Median local control was significantly better for WBRT + SRS compared to SRS alone & WBRT alone (10 vs 6 vs 5 months, respectively, P = 0.04). There was non significant survival benefit for WBRT + SRS compared to SRS alone & WBRT alone. Survival was significantly better for patients with controlled primary tumor who received WBRT + SRS compared to SRS alone & WBRT alone (median survival was 12 vs 5.5 vs 8 months, respectively. P = 0.027). Regardless of the treatment group, median survival and median local control were highly significantly better for single brain site involvement compared to multiple brain sites involvement (P = 0.003 & P = 0.001, respectively), and median brain local control was significantly better for single lesion compared to multiple lesions (P = 0.05).

Conclusions: WBRT + SRS is an effective, safe tool in treatment of patients with 1 to 3 brain metastses improving the brain local control, but further studies with larger number of patients is recommended.

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Figures

Figure 1
Figure 1
Distribution of patients in studied arms according to no. of brain lesions.
Figure 2
Figure 2
Local control of the 3 treatments groups.
Figure 3
Figure 3
The LC according to number of brain lesions.
Figure 4
Figure 4
The LC according to number of brain sites involved.
Figure 5
Figure 5
Overall survival for all patients.
Figure 6
Figure 6
Overall survival for each treatment group.
Figure 7
Figure 7
Overall survival according to number of brain sites involved.
See this image and copyright information in PMC

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