Journal of Neuro-Oncology

, Volume 2, Issue 4, pp 325-330

First online:

Randomized trial of radiotherapy versus radiotherapy plus metronidazole for the treatment metastatic cancer to brain

A Southwest Oncology Group study
  • Harmon J EyreAffiliated withUniversity of Utah Medical Center
  • , Joel D OhlsenAffiliated withUniversity of Utah Medical Center
  • , Jess FrankAffiliated withSouthwest Oncology Group Biostatistical Center
  • , Albert F LoBuglioAffiliated withUniversity of Michigan Medical Center
  • , Joseph D McCrackenAffiliated withBrook Army Medical Center
  • , T J WeatherallAffiliated withTulane University
  • , C M MansfieldAffiliated withUniversity of Kansas Medical Center

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One hundred sixteen eligible patients with metastatic cancer to the brain were randomized to receive either radiotherapy 3000 rad/ 10 fractions (treatment 1) or the same radiotherapy plus metronidazole 6 gm/m2 (treatment 2). One hundred eleven patients were either fully or partially evaluable. The response rates (CR + PR) and survival showed no significant differences between treatments. Treatment 1: CR + PR 24%, median survival 14 weeks, Treatment 2: CR + PR 27%, median survival 12 weeks. There were no differences observed in response rates based on primary tumor site, neurologic performance status, or extent of metastatic disease. Metronidazole therapy was associated with substantial nausea and vomiting but no neurotoxicity was observed. Oral metronidazole given every other day during radiation therapy provided no clinical benefit for patients with brain metastases compared to radiotherapy alone.


brain metastases radiotherapy