TY - JOUR
T1 - Early volumetric change and treatment outcome of metastatic brain tumors after external beam radiotherapy
T2 - Differential radiotherapy for brain metastasis
AU - Lee, D. S.
AU - Kim, Y. S.
AU - Lee, C. G.
AU - Lim, J. H.
AU - Suh, C. O.
AU - Kim, H. J.
AU - Cho, J.
PY - 2013/11
Y1 - 2013/11
N2 - Purpose: To evaluate the treatment outcomes of low-dose whole brain radiation therapy (WBRT)-based differential radiation therapy (RT) for metastatic brain tumors. Methods: A total of 242 targets (metastatic brain lesions) were analyzed in the present study. Median WBRT dose and number of fractions were 25 (range 25-35) Gy and 10 (range 8-15) fractions, respectively. A median normalized total dose (NTD) of 1.8 Gy (NTD1.8Gy) to the metastatic lesion was 45 (range 27-64.8) Gy. We numbered and contoured each metastatic lesion sequentially using computed tomography fused with serial magnetic resonance imaging to evaluate volumetric changes. Results: The 6-month and 1-year freedom from remote intracranial failure rates were 87.7 and 58.5 %, respectively. The 6-month actuarial local control (LC) rate was 93.4 %. Tumor diameter was a major determinant for LC, and tumor histology was a significant parameter predicting the volume reduction rate. With overall complete response (CR) rate of 56.6 % after RT, CR rate, if the target was more than 1 cm in size, was 25 % with a median NTD1.8Gy of 45 Gy, requiring dose escalation to achieve better target regression. Conclusions: Low-dose WBRT with selective boost was feasible and effective. Our results pose the rationale of future trial of differential radiation therapy (RT), which prescribes different radiation dose according to the tumor density in metastatic brain tumors.
AB - Purpose: To evaluate the treatment outcomes of low-dose whole brain radiation therapy (WBRT)-based differential radiation therapy (RT) for metastatic brain tumors. Methods: A total of 242 targets (metastatic brain lesions) were analyzed in the present study. Median WBRT dose and number of fractions were 25 (range 25-35) Gy and 10 (range 8-15) fractions, respectively. A median normalized total dose (NTD) of 1.8 Gy (NTD1.8Gy) to the metastatic lesion was 45 (range 27-64.8) Gy. We numbered and contoured each metastatic lesion sequentially using computed tomography fused with serial magnetic resonance imaging to evaluate volumetric changes. Results: The 6-month and 1-year freedom from remote intracranial failure rates were 87.7 and 58.5 %, respectively. The 6-month actuarial local control (LC) rate was 93.4 %. Tumor diameter was a major determinant for LC, and tumor histology was a significant parameter predicting the volume reduction rate. With overall complete response (CR) rate of 56.6 % after RT, CR rate, if the target was more than 1 cm in size, was 25 % with a median NTD1.8Gy of 45 Gy, requiring dose escalation to achieve better target regression. Conclusions: Low-dose WBRT with selective boost was feasible and effective. Our results pose the rationale of future trial of differential radiation therapy (RT), which prescribes different radiation dose according to the tumor density in metastatic brain tumors.
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U2 - 10.1007/s12094-013-1016-2
DO - 10.1007/s12094-013-1016-2
M3 - Article
C2 - 23408041
AN - SCOPUS:84886582689
SN - 1699-048X
VL - 15
SP - 889
EP - 896
JO - Clinical and Translational Oncology
JF - Clinical and Translational Oncology
IS - 11
ER -
