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


IntroductionThis 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.

Author: Mahmoud M El GanteryHoda M El BakyHesham A El HossienyMohamed MahmoudOsama Youssef
Credits/Source: Radiation Oncology 2014, 9:116

Published on: 2014-05-20

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