TY - JOUR
T1 - Whole-brain radiotherapy combined with surgery or stereotactic radiotherapy in patients with brain oligometastases
T2 - Long-term analysis
AU - D'Agostino, Giuseppe Roberto
AU - Autorino, Rosa
AU - Pompucci, Angelo
AU - De Santis, Maria Carmen
AU - Manfrida, Stefania
AU - Di Lella, Giuseppe
AU - Mantini, Giovanna
AU - Frascino, Vincenzo
AU - Chiesa, Silvia
AU - Albanese, Alessio
AU - Dinapoli, Nicola
AU - Azario, Luigi
AU - Fiorentino, Alba
AU - Valentini, Vincenzo
AU - Anile, Carmelo
AU - Balducci, Mario
PY - 2011/7
Y1 - 2011/7
N2 - Objective: To verify whether the treatment of brain oligometastases with whole-brain radiotherapy (WBRT) plus stereotactic radiotherapy (SRT) or surgical resection results in different outcomes. Methods: Files of patients affected by brain metastases submitted to surgical resection followed by WBRT (group A) or WBRT + SRT (group B) were retrospectively selected for this study. The two treatment groups were matched for the following potential prognostic factors: WBRT schedule, age, gender, performance status, tumor type, number of brain metastases, extra-cerebral metastases, and recursive partitioning analysis class (RPA). The outcomes of patients in both groups were evaluated in terms of toxicity, local control, and overall survival. Results: Total of 97 patients were selected (56 male; 42 female) who were respectively submitted to surgical resection followed by WBRT (group A, n = 50 patients) or WBRT + SRT (Group B, n = 47 patients). Median follow-up was 95 months (range, 8-171 months). The 1-year local control rates were 46.0% and 69.0% respectively. No significant difference in local tumor control was observed between group A and B (p = 0.10). Median overall survival was 15 and 19 months in group A and B, respectively. One-year survival was 56.0% and 62%, respectively. No difference was observed in the two groups (p = 0.40). Conclusion: Surgery remains the main therapeutic approach in symptomatic patients; nevertheless, our data support the use of WBRT plus SRT in one or two brain metastases smaller than 3 cm.
AB - Objective: To verify whether the treatment of brain oligometastases with whole-brain radiotherapy (WBRT) plus stereotactic radiotherapy (SRT) or surgical resection results in different outcomes. Methods: Files of patients affected by brain metastases submitted to surgical resection followed by WBRT (group A) or WBRT + SRT (group B) were retrospectively selected for this study. The two treatment groups were matched for the following potential prognostic factors: WBRT schedule, age, gender, performance status, tumor type, number of brain metastases, extra-cerebral metastases, and recursive partitioning analysis class (RPA). The outcomes of patients in both groups were evaluated in terms of toxicity, local control, and overall survival. Results: Total of 97 patients were selected (56 male; 42 female) who were respectively submitted to surgical resection followed by WBRT (group A, n = 50 patients) or WBRT + SRT (Group B, n = 47 patients). Median follow-up was 95 months (range, 8-171 months). The 1-year local control rates were 46.0% and 69.0% respectively. No significant difference in local tumor control was observed between group A and B (p = 0.10). Median overall survival was 15 and 19 months in group A and B, respectively. One-year survival was 56.0% and 62%, respectively. No difference was observed in the two groups (p = 0.40). Conclusion: Surgery remains the main therapeutic approach in symptomatic patients; nevertheless, our data support the use of WBRT plus SRT in one or two brain metastases smaller than 3 cm.
KW - Brain metastases
KW - Oligometastases
KW - Stereotactic radiotherapy
KW - Surgery
KW - Whole-brain radiotherapy
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U2 - 10.1007/s00066-011-2228-4
DO - 10.1007/s00066-011-2228-4
M3 - Article
C2 - 21713390
AN - SCOPUS:80052098709
VL - 187
SP - 421
EP - 425
JO - Strahlentherapie und Onkologie
JF - Strahlentherapie und Onkologie
SN - 0179-7158
IS - 7
ER -