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Fifty percent patients avoid whole brain radiotherapy: stereotactic radiotherapy for multiple brain metastases. A retrospective analysis of a single center

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Abstract

Purpose

To summarize the outcomes of stereotactic radiotherapy (SRT), with or without whole-brain radiotherapy (WBRT), in the treatment of multiple brain metastasis and to explore the status of WBRT and SRT in the management of multiple brain metastasis.

Methods

From May 1995 to April 2010, 98 patients with newly diagnosed, multiple brain metastasis were treated in our center. Forty-four patients were treated with SRT alone for the initial treatment, and 54 were treated with SRT + WBRT. Kaplan–Meier and Cox proportional hazards regression analyses were used for the survival analysis.

Results

The median survival time (MST) was 13.5 months. No difference was observed in MST between the SRT and the SRT + WBRT groups (p = 0.578). The Karnofsky Performance Score at the time of treatment (p = 0.025), the interval time between diagnosis of primary tumor and brain metastasis (P = 0.012) and the situation of extracranial disease (p = 0.018) were significant predictors of survival. The crude distant intracranial recurrence (DIR) rates were 47.7 % in the SRT group and 24.1 % in the SRT + WBRT group (p = 0.018). In addition, 52.3 % patients in the SRT group were free from DIR and did not require WBRT in their whole lives.

Conclusions

Our data suggest that use of SRT as the initial treatment while reserving WBRT as the salvage therapy in case of distant intracranial recurrence made about 50 % of the patients avoid WBRT throughout the course of their lives and may be another optional treatment modality for multiple brain metastases.

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Conflict of interest

The authors declare that there is no actual or potential conflict of interest in relation to this article.

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Authors and Affiliations

  1. Department of Radiation Oncology, Cancer Hospital (Institute), Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China

    Xiujun Chen, Jianping Xiao, Xiangpan Li, Xuesong Jiang, Ye Zhang, Yingjie Xu & Jianrong Dai

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  1. Xiujun Chen
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  2. Jianping Xiao
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  3. Xiangpan Li
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  4. Xuesong Jiang
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  5. Ye Zhang
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Correspondence to Jianping Xiao.

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Chen, X., Xiao, J., Li, X. et al. Fifty percent patients avoid whole brain radiotherapy: stereotactic radiotherapy for multiple brain metastases. A retrospective analysis of a single center. Clin Transl Oncol 14, 599–605 (2012). https://doi.org/10.1007/s12094-012-0849-4

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  • DOI: https://doi.org/10.1007/s12094-012-0849-4

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