Re-irradiation for metastatic brain tumors with whole-brain radiotherapy.

نویسندگان

  • Takeshi Akiba
  • Etsuo Kunieda
  • Asuka Kogawa
  • Tetsuya Komatsu
  • Yoshifumi Tamai
  • Yukio Ohizumi
چکیده

OBJECTIVE To determine whether second whole-brain irradiation is beneficial for patients previously treated with whole-brain irradiation. METHODS A retrospective analysis was done for 31 patients with brain metastases who had undergone re-irradiation. Initial whole-brain irradiation was performed with 30 Gy/10 fractions for 87% of these patients. Whole-brain re-irradiation was performed with 30 Gy/10 fractions for 42% of these patients (3-40 Gy/1-20 fractions). Three patients underwent a third whole-brain irradiation. RESULTS The median interval between the initial irradiation and re-irradiation was 10 months (range: 2-69 months). The median survival time after re-irradiation was 4 months (range: 1-21 months). The symptomatic improvement rate after re-irradiation was 68%, and the partial and complete tumor response rate was 55%. Fifty-two percent of the patients developed Grade 1 acute reactions. On magnetic resonance imaging, brain atrophy was observed in 36% of these patients after the initial irradiation and 74% after re-irradiation. Grade ≥2 encephalopathy or cognitive disturbance was observed in 10 patients (32%) after re-irradiation. Based on univariate analysis, significant factors related to survival after re-irradiation were the location of the primary cancer (P = 0.003) and the Karnofsky performance status at the time of re-irradiation (P = 0.008). A Karnofsky performance status ≥70 was significant based on multivariate analysis (P = 0.050). CONCLUSIONS Whole-brain re-irradiation for brain metastases placed only a slight burden on patients and was effective for symptomatic improvement. However, their remaining survival time was limited and the incidence of cognitive disturbance was rather high.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Is Re-Irradiation of Recurrent Metastatic Brain Tumors an Option? Re-Irradiation for Metastatic Brain Tumors With Whole-Brain Radiotherapy

Background: Relapse after whole-brain radiation therapy (WBRT) for multiple cerebral metastases occurs fairly often and is associated with a poor prognosis. Re-irradiation is an option that many defer because of risks of exceeding brain tolerance and resulting toxicity. Objective: To determine if brain re-irradiation is beneficial. Design: Single-institution retrospective study. Methods: Patien...

متن کامل

Re-irradiation in the treatment of patients with cerebral metastases of solid tumors: retrospective analysis

BACKGROUND Goal of this retrospective analysis was to evaluate the role of repeat whole brain radiotherapy in the palliative care of patients with brain metastases due to solid tumors. METHODS Data regarding demographic data, primary tumor, metastasis, radiotherapy and symptoms were compiled on 134 patients with cerebral metastases that received repeat whole brain radiotherapy (WBRT) in our c...

متن کامل

Pulsed reduced dose-rate radiotherapy as re-irradiation for brain metastasis in a patient with lung squamous-celled carcinoma.

The recurrence and progression of brain metastases after brain irradiation are a major cause of mortality and morbidity in patients with cancer. The risk of radiation-induced neurotoxicity and efficacy probably leads oncologists to not consider re-irradiation. We report the case of a 48-year-old Asian male diagnosed with squamous cell lung cancer and multiple brain metastases initially treated ...

متن کامل

Unusual presentation of gestational trophoblastic neoplasm: Report of two cases

  Abstract: Gestational Trophoblastic Neoplasm (GTN) is among rare human tumors which can be observed with widespread metastasis. Two young patients with emergent neurologic symptoms with no gynecological problems are presented in this report. GTN was later diagnosed in both cases with brain metastasis. The first case: A 22 years old patient, admitted to the infectious disease ward, with probab...

متن کامل

Is Hippocampal Avoidance During Whole-Brain Radiotherapy Risky for Patients With Small-Cell Lung Cancer? Hippocampal Metastasis Rate and Associated Risk Factors

OBJECTIVES Hippocampal avoidance during whole-brain radiotherapy is performed to prevent neural stem cell injury causing neurocognitive dysfunction. Nevertheless, the estimated risk of metastases in hippocampal avoidance area in small-cell lung cancer is unknown. The current study aimed to characterize the metastatic distribution within the brain relative to the hippocampus, estimate the incide...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Japanese journal of clinical oncology

دوره 42 4  شماره 

صفحات  -

تاریخ انتشار 2012