Whole-brain radiotherapy plus sequential or simultaneous integrated boost for the treatment of a limited number of brain metastases in non-small cell lung cancer: A single-institution study

Qing, D.; Zhao, B.; Zhou, Y.-C.; Zhu, H.-L.; Ma, D.-Y. ✉

Angol nyelvű Szakcikk (Folyóiratcikk) Tudományos
Megjelent: CANCER MEDICINE 2045-7634 9 (1) pp. 238-246 2020
  • SJR Scopus - Radiology, Nuclear Medicine and Imaging: Q1
Background: To compare the survival outcomes and neurocognitive dysfunction in non-small cell lung cancer (NSCLC) patients with brain metastases (BM ≤10) treated by whole-brain radiotherapy (WBRT) with sequential integrated boost (SEB) or simultaneous integrated boost (SIB). Materials: Fifty-two NSCLC patients with a limited number of BMs were retrospectively analyzed. Twenty cases received WBRT+SEB (WBRT: 3 Gy*10 fractions and BMs: 4 Gy*3 fractions; SEB group), and 32 cases received WBRT+SIB (WBRT: 3 Gy*10 fractions and BMs: 4 Gy*10 fractions; SIB group). The survival and mini-mental state examination (MMSE) scores were compared between the groups. Results: The cumulative 1-, 2-, and 3-year survival rates in the SEB vs SIB groups were 60.0% vs 47.8%, 41.1% vs 19.1%, and 27.4% vs 0%, respectively. The median survival times in the SEB and SIB groups were 15 and 10 months, respectively. The difference in survival rate was significant (P =.046). Subgroup analysis revealed that 1-, 2-, and 3-year survival rates and median survival time in the SEB group were significantly superior to those of the SIB group, especially for male patients (age <60 years) with 1-2 BMs (P <.05). The MMSE score of the SEB group at 3 months after radiation was higher than that of the SIB group (P <.05). Nevertheless, WBRT+SEB required a longer treatment time and greater cost (P <.005). Conclusions: WBRT + SEB results in better survival outcomes than WBRT+SIB, especially for male patients (age <60 years) with 1-2 BMs. WBRT+SEB also appeared to induce less neurocognitive impairment than WBRT+SIB. © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
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2022-05-24 17:38