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Int. J. Mol. Sci. 2014, 15(5), 7554-7562; doi:10.3390/ijms15057554

3D Radiation Therapy Boost Improves the Outcome of Whole Brain Radiation Therapy Treated RPA II Patients with One or Two Brain Metastases

Radiotherapy Department, Centre de Lutte Contre le Cancer Paul Strauss, 3, rue de la Porte de L'Hôpital, 67065 Strasbourg Cedex, France
Laboratory of Biostatistics, Faculté de Médecine, 4, rue Kirschleger, 67085 Strasbourg Cedex, France
Author to whom correspondence should be addressed.
Received: 6 February 2014 / Revised: 7 April 2014 / Accepted: 24 April 2014 / Published: 2 May 2014
(This article belongs to the Special Issue Brain Metastasis 2014)
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Purpose: to evaluate the role of whole brain radiotherapy (WBRT) and radiation boost (RB) for 208 patients recursive partitioning analysis (RPA) II with 1 or 2 brain metastases (BM) at a single institution. Methods and Materials: the dose of WBRT was 30 Gy (10 fractions of 3 Gy). One hundred thirty-two patients (63.5%) benefited from RB of 9 Gy in 3 fractions of 3 Gy at the metastatic site. Patients had 1 or 2 BM in 122 (58.7%) and 86 cases (41.3%), respectively. Results: patients with one or two metastases had similar survival (4.6 and 5.1 months, respectively) (p = 0.4). Median overall survival (OS) for patients treated with WBRT and RB, and with WBRT alone was 5.9 and 3.7 months, respectively (p = 0.03). The 6-, 12- and 24-month OS rates after WBRT and RB were 48.5%, 25% and 10.6%, respectively, while WBRT alone resulted in OS rates of 34%, 22.4% and 3.2%, respectively (p = 0.03). After WBRT and RB, the 6-, 12- and 24-month local control rates were 92%, 82% and 67%, respectively, while they were 81.2%, 75% and 37.5%, respectively, after WBRT alone (p = 0.03). The 6-, 12- and 24-month brain control rates after WBRT and RB were 88.7%, 75.8% and 62%, respectively, and after WBRT alone they were 78.5%, 59% and 37.7%, respectively (p = 0.03). Conclusion: additional boost delivered with 3D conformal radiotherapy improves local and brain control rates significantly as well as overall survival for RPA II patients with 1 or 2 unresectable BM. View Full-Text
Keywords: brain metastases; whole brain radiotherapy; radiation boost brain metastases; whole brain radiotherapy; radiation boost

This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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Antoni, D.; Clavier, J.-B.; Pop, M.; Schumacher, C.; Lefebvre, F.; Noël, G. 3D Radiation Therapy Boost Improves the Outcome of Whole Brain Radiation Therapy Treated RPA II Patients with One or Two Brain Metastases. Int. J. Mol. Sci. 2014, 15, 7554-7562.

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