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Optimal dose and volume for postoperative radiotherapy in brain oligometastases from lung cancer: a retrospective study

 Seung Yeun Chung  ;  Jong Hee Chang  ;  Hye Ryun Kim  ;  Byoung Chul Cho  ;  Chang Geol Lee  ;  Chang-Ok Suh 
 RADIATION ONCOLOGY JOURNAL, Vol.35(2) : 153-162, 2017 
Journal Title
Issue Date
Adjuvant radiotherapy ; Lung neopla는 ; Neoplasm metastasis
PURPOSE: To evaluate intracranial control after surgical resection according to the adjuvant treatment received in order to assess the optimal radiotherapy (RT) dose and volume.

MATERIALS AND METHODS: Between 2003 and 2015, a total of 53 patients with brain oligometastases from non-small cell lung cancer (NSCLC) underwent metastasectomy. The patients were divided into three groups according to the adjuvant treatment received: whole brain radiotherapy (WBRT) ± boost (WBRT ± boost group, n = 26), local RT/Gamma Knife surgery (local RT group, n = 14), and the observation group (n = 13). The most commonly used dose schedule was WBRT (25 Gy in 10 fractions, equivalent dose in 2 Gy fractions [EQD2] 26.04 Gy) with tumor bed boost (15 Gy in 5 fractions, EQD2 16.25 Gy).

RESULTS: The WBRT ± boost group showed the lowest 1-year intracranial recurrence rate of 30.4%, followed by the local RT and observation groups, at 66.7%, and 76.9%, respectively (p = 0.006). In the WBRT ± boost group, there was no significant increase in the 1-year new site recurrence rate of patients receiving a lower dose of WBRT (EQD2) <27 Gy compared to that in patients receiving a higher WBRT dose (p = 0.553). The 1-year initial tumor site recurrence rate was lower in patients receiving tumor bed dose (EQD2) of ≥42.3 Gy compared to those receiving <42.3 Gy, although the difference was not significant (p = 0.347).

CONCLUSIONS: Adding WBRT after resection of brain oligometastases from NSCLC seems to enhance intracranial control. Furthermore, combining lower-dose WBRT with a tumor bed boost may be an attractive option.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hye Ryun(김혜련) ORCID logo https://orcid.org/0000-0002-1842-9070
Suh, Chang Ok(서창옥)
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
Cho, Byoung Chul(조병철) ORCID logo https://orcid.org/0000-0002-5562-270X
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