J Korean Soc Ther Radiol Oncol.  2009 Sep;27(3):163-168. 10.3857/jkstro.2009.27.3.163.

Comparison of Stereotactic Radiosurgery and Whole Brain Radiotherapy in Patients with Four or More Brain Metastases

• Kim C
• Baek M
• Park S
• Ahn K
• Cho H

• KMID: 2097245
• DOI: http://doi.org/10.3857/jkstro.2009.27.3.163

Abstract

PURPOSE
This study was a retrospective evaluation of the efficacy of stereotactic radiosurgery (SRS) in patients with >4 metastases to the brain.
MATERIALS AND METHODS
Between January 2004 and December 2006, 68 patients with > or = 4 multiple brain metastases were included and reviewed retrospectively. Twenty-nine patients received SRS and 39 patients received whole brain radiotherapy (WBRT). Patients with small cell lung cancers and melanomas were excluded. The primary lesions were non-small cell lung cancer (69.0%) and breast cancer (13.8%) in the SRS group and non-small cell lung cancer (64.1%), breast cancer (15.4%), colorectal cancer (12.8%), esophageal cancer (5.1%) in the WBRT group. SRS involved gamma-knife radiosurgery and delivered 10~20 Gy (median, 16 Gy) in a single fraction with a 50% marginal dose. WBRT was delivered daily in 3 Gy fractions, for a total of 30 Gy. After completion of treatment, a follow-up brain MRI or a contrast-enhanced brain CT was reviewed. The overall survival and intracranial progression-free survival were compared in each group.
RESULTS
The median follow-up period was 5 months (range, 2~19 months) in the SRS group and 6 months (range, 4~23 months) in the WBRT group. The mean number of metastatic lesions in the SRS and WBRT groups was 6 and 5, respectively. The intracranial progression-free survival and overall survival in the SRS group was 5.1 and 5.6 months, respectively, in comparison to 6.1 and 7.2 months, respectively, in the WBRT group.
CONCLUSION
SRS was less effective than WBRT in the treatment of patients with >4 metastases to the brain.

Keyword

Multiple brain metastases; Stereotactic radiosurgery; Whole brain radiotherapy

MeSH Terms

Brain
Breast Neoplasms
Carcinoma, Non-Small-Cell Lung
Colorectal Neoplasms
Disease-Free Survival
Esophageal Neoplasms
Follow-Up Studies
Humans
Lung Neoplasms
Melanoma
Neoplasm Metastasis
Radiosurgery
Retrospective Studies