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The benefit of whole brain reirradiation in patients with multiple brain metastases

BACKGROUND: To assess the outcomes, symptom palliation and survival rates in patients who received repeat whole brain radiotherapy (WBRT). METHODS: Twenty-eight patients who had progression of brain metastasis received a second course of WBRT. Univariate log-rank testing and multivariate Cox regress...

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Autores principales: Ozgen, Zerrin, Atasoy, Beste M, Ucuncu Kefeli, Aysegul, Seker, Askin, Dane, Faysal, Abacioglu, Ufuk
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3726464/
https://www.ncbi.nlm.nih.gov/pubmed/23879889
http://dx.doi.org/10.1186/1748-717X-8-186
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author Ozgen, Zerrin
Atasoy, Beste M
Ucuncu Kefeli, Aysegul
Seker, Askin
Dane, Faysal
Abacioglu, Ufuk
author_facet Ozgen, Zerrin
Atasoy, Beste M
Ucuncu Kefeli, Aysegul
Seker, Askin
Dane, Faysal
Abacioglu, Ufuk
author_sort Ozgen, Zerrin
collection PubMed
description BACKGROUND: To assess the outcomes, symptom palliation and survival rates in patients who received repeat whole brain radiotherapy (WBRT). METHODS: Twenty-eight patients who had progression of brain metastasis received a second course of WBRT. Univariate log-rank testing and multivariate Cox regression analysis were used to determine the factors for death among several variables (cumulative BED [BEDcumulative], primary tumor site, Karnofsky performance scale [KPS], previous SRS, number of metastases and absence of extracranial metastases). Correlations between variables and treatment response were evaluated with the Chi-squared test. RESULTS: The median KPS was 60 (range 50 to 100) at the initiation of reirradiation. The median time interval between the two courses of WBRT was 9.5 months (range 3–27 months). The median doses of the first course and the second course of WBRT were 30 Gy (range 20 to 30 Gy) and 25 Gy (range 20 to 30 Gy), respectively. The mean BEDcumulative was 129.5 Gy (range 110 to 150 Gy). Severe or unexpected toxicity was not observed. Symptomatic response was detected in 39% of the patients. The median overall survival following reirradiation was 3 months (range 1 to 12 months, 95% CI 1.82-4.118). Survival was significantly better in responders (median 10 months, 95% CI 3.56-16.43) compared with non-responders (median 2 months, 95% CI 1.3-2.64) (p = 0.000). In multivariate analysis, patients that had lung cancer (p = 0.01), initial KPS ≥60 (p = 0.03) or longer intervals to reirradiation (p = 0.01) had significantly better survival rates. CONCLUSIONS: A careful second course of whole brain irradiation might provide a symptomatic and survival benefit in patients with good performance status and longer cranial progression-free intervals.
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spelling pubmed-37264642013-07-30 The benefit of whole brain reirradiation in patients with multiple brain metastases Ozgen, Zerrin Atasoy, Beste M Ucuncu Kefeli, Aysegul Seker, Askin Dane, Faysal Abacioglu, Ufuk Radiat Oncol Research BACKGROUND: To assess the outcomes, symptom palliation and survival rates in patients who received repeat whole brain radiotherapy (WBRT). METHODS: Twenty-eight patients who had progression of brain metastasis received a second course of WBRT. Univariate log-rank testing and multivariate Cox regression analysis were used to determine the factors for death among several variables (cumulative BED [BEDcumulative], primary tumor site, Karnofsky performance scale [KPS], previous SRS, number of metastases and absence of extracranial metastases). Correlations between variables and treatment response were evaluated with the Chi-squared test. RESULTS: The median KPS was 60 (range 50 to 100) at the initiation of reirradiation. The median time interval between the two courses of WBRT was 9.5 months (range 3–27 months). The median doses of the first course and the second course of WBRT were 30 Gy (range 20 to 30 Gy) and 25 Gy (range 20 to 30 Gy), respectively. The mean BEDcumulative was 129.5 Gy (range 110 to 150 Gy). Severe or unexpected toxicity was not observed. Symptomatic response was detected in 39% of the patients. The median overall survival following reirradiation was 3 months (range 1 to 12 months, 95% CI 1.82-4.118). Survival was significantly better in responders (median 10 months, 95% CI 3.56-16.43) compared with non-responders (median 2 months, 95% CI 1.3-2.64) (p = 0.000). In multivariate analysis, patients that had lung cancer (p = 0.01), initial KPS ≥60 (p = 0.03) or longer intervals to reirradiation (p = 0.01) had significantly better survival rates. CONCLUSIONS: A careful second course of whole brain irradiation might provide a symptomatic and survival benefit in patients with good performance status and longer cranial progression-free intervals. BioMed Central 2013-07-24 /pmc/articles/PMC3726464/ /pubmed/23879889 http://dx.doi.org/10.1186/1748-717X-8-186 Text en Copyright © 2013 Ozgen 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
Ozgen, Zerrin
Atasoy, Beste M
Ucuncu Kefeli, Aysegul
Seker, Askin
Dane, Faysal
Abacioglu, Ufuk
The benefit of whole brain reirradiation in patients with multiple brain metastases
title The benefit of whole brain reirradiation in patients with multiple brain metastases
title_full The benefit of whole brain reirradiation in patients with multiple brain metastases
title_fullStr The benefit of whole brain reirradiation in patients with multiple brain metastases
title_full_unstemmed The benefit of whole brain reirradiation in patients with multiple brain metastases
title_short The benefit of whole brain reirradiation in patients with multiple brain metastases
title_sort benefit of whole brain reirradiation in patients with multiple brain metastases
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3726464/
https://www.ncbi.nlm.nih.gov/pubmed/23879889
http://dx.doi.org/10.1186/1748-717X-8-186
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