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Early volumetric change and treatment outcome of metastatic brain tumors after external beam radiotherapy: differential radiotherapy for brain metastasis.

 D. S. Lee  ;  Y. S. Kim  ;  C. G. Lee  ;  J. H. Lim  ;  C.-O. Suh  ;  H. J. Kim  ;  J. Cho 
 CLINICAL & TRANSLATIONAL ONCOLOGY, Vol.15(11) : 889-896, 2013 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Brain Neoplasms/mortality ; Brain Neoplasms/radiotherapy* ; Brain Neoplasms/secondary* ; Cranial Irradiation* ; Dose Fractionation* ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Staging ; Neoplasms/mortality ; Neoplasms/pathology ; Neoplasms/radiotherapy* ; Retrospective Studies ; Survival Rate ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult
Boost ; Brain Metastases ; Radiotherapy
PURPOSE: To evaluate the treatment outcomes of low-dose whole brain radiation therapy (WBRT)-based differential radiation therapy (RT) for metastatic brain tumors. METHODS: A total of 242 targets (metastatic brain lesions) were analyzed in the present study. Median WBRT dose and number of fractions were 25 (range 25-35) Gy and 10 (range 8-15) fractions, respectively. A median normalized total dose (NTD) of 1.8 Gy (NTD(1.8Gy)) to the metastatic lesion was 45 (range 27-64.8) Gy. We numbered and contoured each metastatic lesion sequentially using computed tomography fused with serial magnetic resonance imaging to evaluate volumetric changes. RESULTS: The 6-month and 1-year freedom from remote intracranial failure rates were 87.7 and 58.5 %, respectively. The 6-month actuarial local control (LC) rate was 93.4 %. Tumor diameter was a major determinant for LC, and tumor histology was a significant parameter predicting the volume reduction rate. With overall complete response (CR) rate of 56.6 % after RT, CR rate, if the target was more than 1 cm in size, was 25 % with a median NTD(1.8Gy) of 45 Gy, requiring dose escalation to achieve better target regression. CONCLUSIONS: Low-dose WBRT with selective boost was feasible and effective. Our results pose the rationale of future trial of differential radiation therapy (RT), which prescribes different radiation dose according to the tumor density in metastatic brain tumors.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Suh, Chang Ok(서창옥)
Lee, Dong Soo(이동수)
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
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