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Risk factors of distant brain failure for patients with newly diagnosed brain metastases treated with stereotactic radiotherapy alone
OBJECTIVE: To explore the risk factors of distant brain failure (DBF) for patients with brain metastasis (BM) who were treated with stereotactic radiotherapy alone and to group the patients on the basis of their risk levels. METHODS AND MATERIALS: We retrospectively analyzed 132 newly diagnosed BM p...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3274494/ https://www.ncbi.nlm.nih.gov/pubmed/22182786 http://dx.doi.org/10.1186/1748-717X-6-175 |
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author | Chen, Xiu-jun Xiao, Jian-ping Li, Xiang-pan Jiang, Xue-song Zhang, Ye Xu, Ying-jie Dai, Jian-rong Li, Ye-xiong |
author_facet | Chen, Xiu-jun Xiao, Jian-ping Li, Xiang-pan Jiang, Xue-song Zhang, Ye Xu, Ying-jie Dai, Jian-rong Li, Ye-xiong |
author_sort | Chen, Xiu-jun |
collection | PubMed |
description | OBJECTIVE: To explore the risk factors of distant brain failure (DBF) for patients with brain metastasis (BM) who were treated with stereotactic radiotherapy alone and to group the patients on the basis of their risk levels. METHODS AND MATERIALS: We retrospectively analyzed 132 newly diagnosed BM patients who were treated with stereotactic radiotherapy alone from May 2000 to April 2010. Kaplan-Meier and Cox proportional hazards regression analyses were performed for univariate and multivariate analyses. RESULTS: The 1-year incidence rate of DBF was 44.7%, and the median DBF time (MDBFT) was 18 months. In multivariate analysis, the risk factors of DBF were the number of BMs greater than 1 (p = 0.041), uncontrolled extracranial disease (p = 0.005), interval time (IT) of less than 60 months between the diagnosis of primary tumor and BM (p = 0.024), and total volume of BM was greater than 6 cc (p = 0.049). Each risk factor was assigned 1 score. The median survival times for the patients with scores of 0-1, 2-3, and 4 were 31, 12, and 10 months, respectively, and the corresponding MDBFTs were not reached, 13, and 3 months, respectively, (p < 0.001). The crude DBF incidence rates in patients with scores of 0-1, 2-3, and 4 were 14.8%, 50.0%, and 76.9%, respectively, (p < 0.001). CONCLUSIONS: The patients with scores of 0-1 had a lower risk of DBF than the patients with higher scores did, and it may be reasonable to treat these patients with SRS alone and resort to whole-brain radiation therapy only for salvage. The patients with a score of 4 had the highest risk of developing DBF after stereotactic radiotherapy alone, these patients may be candidates for initial whole-brain radiation therapy or clinical trials. The patients with a score of 2-3 had a moderate risk of developing DBF, SRT alone combined with close clinical monitoring would be the optimal treatment regimen for such patients, and for those patients with difficulties in receiving close clinical mornitoring, SRT combined with WBRT will be more suitable. |
format | Online Article Text |
id | pubmed-3274494 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-32744942012-02-08 Risk factors of distant brain failure for patients with newly diagnosed brain metastases treated with stereotactic radiotherapy alone Chen, Xiu-jun Xiao, Jian-ping Li, Xiang-pan Jiang, Xue-song Zhang, Ye Xu, Ying-jie Dai, Jian-rong Li, Ye-xiong Radiat Oncol Research OBJECTIVE: To explore the risk factors of distant brain failure (DBF) for patients with brain metastasis (BM) who were treated with stereotactic radiotherapy alone and to group the patients on the basis of their risk levels. METHODS AND MATERIALS: We retrospectively analyzed 132 newly diagnosed BM patients who were treated with stereotactic radiotherapy alone from May 2000 to April 2010. Kaplan-Meier and Cox proportional hazards regression analyses were performed for univariate and multivariate analyses. RESULTS: The 1-year incidence rate of DBF was 44.7%, and the median DBF time (MDBFT) was 18 months. In multivariate analysis, the risk factors of DBF were the number of BMs greater than 1 (p = 0.041), uncontrolled extracranial disease (p = 0.005), interval time (IT) of less than 60 months between the diagnosis of primary tumor and BM (p = 0.024), and total volume of BM was greater than 6 cc (p = 0.049). Each risk factor was assigned 1 score. The median survival times for the patients with scores of 0-1, 2-3, and 4 were 31, 12, and 10 months, respectively, and the corresponding MDBFTs were not reached, 13, and 3 months, respectively, (p < 0.001). The crude DBF incidence rates in patients with scores of 0-1, 2-3, and 4 were 14.8%, 50.0%, and 76.9%, respectively, (p < 0.001). CONCLUSIONS: The patients with scores of 0-1 had a lower risk of DBF than the patients with higher scores did, and it may be reasonable to treat these patients with SRS alone and resort to whole-brain radiation therapy only for salvage. The patients with a score of 4 had the highest risk of developing DBF after stereotactic radiotherapy alone, these patients may be candidates for initial whole-brain radiation therapy or clinical trials. The patients with a score of 2-3 had a moderate risk of developing DBF, SRT alone combined with close clinical monitoring would be the optimal treatment regimen for such patients, and for those patients with difficulties in receiving close clinical mornitoring, SRT combined with WBRT will be more suitable. BioMed Central 2011-12-19 /pmc/articles/PMC3274494/ /pubmed/22182786 http://dx.doi.org/10.1186/1748-717X-6-175 Text en Copyright ©2011 Chen et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Chen, Xiu-jun Xiao, Jian-ping Li, Xiang-pan Jiang, Xue-song Zhang, Ye Xu, Ying-jie Dai, Jian-rong Li, Ye-xiong Risk factors of distant brain failure for patients with newly diagnosed brain metastases treated with stereotactic radiotherapy alone |
title | Risk factors of distant brain failure for patients with newly diagnosed brain metastases treated with stereotactic radiotherapy alone |
title_full | Risk factors of distant brain failure for patients with newly diagnosed brain metastases treated with stereotactic radiotherapy alone |
title_fullStr | Risk factors of distant brain failure for patients with newly diagnosed brain metastases treated with stereotactic radiotherapy alone |
title_full_unstemmed | Risk factors of distant brain failure for patients with newly diagnosed brain metastases treated with stereotactic radiotherapy alone |
title_short | Risk factors of distant brain failure for patients with newly diagnosed brain metastases treated with stereotactic radiotherapy alone |
title_sort | risk factors of distant brain failure for patients with newly diagnosed brain metastases treated with stereotactic radiotherapy alone |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3274494/ https://www.ncbi.nlm.nih.gov/pubmed/22182786 http://dx.doi.org/10.1186/1748-717X-6-175 |
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