PMID- 23879889
OWN - NLM
STAT- MEDLINE
DCOM- 20150512
LR  - 20220310
IS  - 1748-717X (Electronic)
IS  - 1748-717X (Linking)
VI  - 8
DP  - 2013 Jul 24
TI  - The benefit of whole brain reirradiation in patients with multiple brain 
      metastases.
PG  - 186
LID - 10.1186/1748-717X-8-186 [doi]
AB  - 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.
FAU - Ozgen, Zerrin
AU  - Ozgen Z
FAU - Atasoy, Beste M
AU  - Atasoy BM
FAU - Kefeli, Aysegul Ucuncu
AU  - Kefeli AU
FAU - Seker, Askin
AU  - Seker A
FAU - Dane, Faysal
AU  - Dane F
FAU - Abacioglu, Ufuk
AU  - Abacioglu U
LA  - eng
PT  - Journal Article
DEP - 20130724
PL  - England
TA  - Radiat Oncol
JT  - Radiation oncology (London, England)
JID - 101265111
SB  - IM
MH  - Adult
MH  - Aged
MH  - Brain Neoplasms/*mortality/*radiotherapy/*secondary
MH  - Cranial Irradiation/*methods
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local/mortality/radiotherapy
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Salvage Therapy/*methods
MH  - Treatment Outcome
PMC - PMC3726464
EDAT- 2013/07/25 06:00
MHDA- 2015/05/13 06:00
PMCR- 2013/07/24
CRDT- 2013/07/25 06:00
PHST- 2013/05/07 00:00 [received]
PHST- 2013/07/21 00:00 [accepted]
PHST- 2013/07/25 06:00 [entrez]
PHST- 2013/07/25 06:00 [pubmed]
PHST- 2015/05/13 06:00 [medline]
PHST- 2013/07/24 00:00 [pmc-release]
AID - 1748-717X-8-186 [pii]
AID - 10.1186/1748-717X-8-186 [doi]
PST - epublish
SO  - Radiat Oncol. 2013 Jul 24;8:186. doi: 10.1186/1748-717X-8-186.