Whole brain radiation therapy in management of brain metastasis: results and prognostic factors
<p>Abstract</p> <p>Purpose</p> <p>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, st...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2006-06-01
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| Series: | Radiation Oncology |
| Online Access: | http://www.ro-journal.com/content/1/1/20 |
| _version_ | 1818927524366778368 |
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| author | Pellizzon Cassio A Novaes Paulo E Nakamura Ricardo A Ferrigno Robson Viani Gustavo A Saito Elisa Y Fogaroli Ricardo C Conte Maria A Salvajoli Joao V |
| author_facet | Pellizzon Cassio A Novaes Paulo E Nakamura Ricardo A Ferrigno Robson Viani Gustavo A Saito Elisa Y Fogaroli Ricardo C Conte Maria A Salvajoli Joao V |
| author_sort | Pellizzon Cassio A |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Purpose</p> <p>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.</p> <p>Patients and methods</p> <p>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.</p> <p>Results</p> <p>The OS in 1, 2 and 3 years was 25, 1%, 10, 4% e 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.</p> <p>Conclusion</p> <p>In this series, the patients with higher perform status, RPA class I, and treated with surgery followed by whole brain radiotherapy had better survival.</p> <p>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.</p> |
| first_indexed | 2024-12-20T03:14:23Z |
| format | Article |
| id | doaj.art-8e280449c741475580c6713f92f28bcb |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-20T03:14:23Z |
| publishDate | 2006-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-8e280449c741475580c6713f92f28bcb2022-12-21T19:55:22ZengBMCRadiation Oncology1748-717X2006-06-01112010.1186/1748-717X-1-20Whole brain radiation therapy in management of brain metastasis: results and prognostic factorsPellizzon Cassio ANovaes Paulo ENakamura Ricardo AFerrigno RobsonViani Gustavo ASaito Elisa YFogaroli Ricardo CConte Maria ASalvajoli Joao V<p>Abstract</p> <p>Purpose</p> <p>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.</p> <p>Patients and methods</p> <p>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.</p> <p>Results</p> <p>The OS in 1, 2 and 3 years was 25, 1%, 10, 4% e 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.</p> <p>Conclusion</p> <p>In this series, the patients with higher perform status, RPA class I, and treated with surgery followed by whole brain radiotherapy had better survival.</p> <p>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.</p>http://www.ro-journal.com/content/1/1/20 |
| spellingShingle | Pellizzon Cassio A Novaes Paulo E Nakamura Ricardo A Ferrigno Robson Viani Gustavo A Saito Elisa Y Fogaroli Ricardo C Conte Maria A Salvajoli Joao V Whole brain radiation therapy in management of brain metastasis: results and prognostic factors Radiation Oncology |
| title | Whole brain radiation therapy in management of brain metastasis: results and prognostic factors |
| title_full | Whole brain radiation therapy in management of brain metastasis: results and prognostic factors |
| title_fullStr | Whole brain radiation therapy in management of brain metastasis: results and prognostic factors |
| title_full_unstemmed | Whole brain radiation therapy in management of brain metastasis: results and prognostic factors |
| title_short | Whole brain radiation therapy in management of brain metastasis: results and prognostic factors |
| title_sort | whole brain radiation therapy in management of brain metastasis results and prognostic factors |
| url | http://www.ro-journal.com/content/1/1/20 |
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