Efficacy and toxicity of whole brain radiotherapy in patients with multiple cerebral metastases from malignant melanoma

Radiation Oncology

Stephanie E Combs¹  Jürgen Debus¹  Florian Sterzing¹  Stefan Rieken¹  Daniel Habermehl¹  Jan-Oliver Dittmar¹  Henrik Hauswald¹ 

[1] Department of Radiation Oncology, University of Heidelberg, INF 400, Heidelberg, 69120, Germany

关键词: Whole brain radiotherapy;    WBRT;    Radiotherapy;    Irradiation;    Brain metastases;    Malignant melanoma;   

Others  :  1155465
DOI  :  10.1186/1748-717X-7-130

 received in 2012-05-23, accepted in 2012-07-26,  发布年份 2012

【 摘 要 】

Background

To retrospectively access outcome and toxicity of whole brain radiotherapy (WBRT) in patients with multiple brain metastases (BM) from malignant melanoma (MM).

Patients and methods

Results of 87 patients (median age 58 years; 35 female, 52 male) treated by WBRT for BM of MM between 2000 and 2011 were reviewed. Total dose applied was either 30 Gy in 10 fractions (n = 56) or 40 Gy in 20 fractions (n = 31). All but 9 patients suffered from extra-cerebral metastases. Prior surgical resection of BM was performed in 18 patients, salvage stereotactic radiosurgery in 13 patients.

Results

Mean follow-up was 8 months (range, 0–57 months), the 6- and 12-months overall-(OS) survival rates were 29.2% and 16.5%, respectively. The median OS was 3.5 months. In cerebral follow-up imaging 6 (11) patients showed a complete (partial) remission, while 11 (17) patients had stable disease (intra-cerebral tumor progression). In comparison of total dose, the group treated with 40 Gy in 20 fractions achieved a significant longer OS (p = 0.003, median 3.1 vs. 5.6 months). Furthermore, DS-GPA score (p < 0.001) as well as RPA class (p < 0.001) influenced significantly on OS and patients had a significantly longer OS after surgical resection (p = 0.001, median 3.0 vs. 5.8 months, multivariate p = 0.007). Having extra-cerebral metastases didn't significantly impact on OS (p = 0.21).

Conclusion

Treatment of BM from MM with WBRT is tolerated well and some remissions of BM could be achieved. An advantage for higher treatment total doses was seen. However, outcome is non-satisfying, and further improvements in treatment of BM from MM are warranted.

【 授权许可】

   
2012 Hauswald et al.; licensee BioMed Central Ltd.

【 图 表 】

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