Additional radiation boost to whole brain radiation therapy for brain metastases in small cell lung cancer - A Phase II Study

摘要

Background : Radiation boost has been used effectively in combination with WBRT in various schedules as an effective and possible therapy option in small cell lung cancer ( SCLC ) with brain metastases. The present phase II single institution study was aimed to evaluate the efficiency of additional radiation boost to whole brain radiation therapy for brain metastases (BMs) in SCLC at Department of Clinical Oncology, Faculty of Medicine, Tanta university Hospital. Patients and Methods: 36 patients, their ages 18 years with brain metastases in SCLC , adequate hepatic, renal and hematologic function, no less than one assessable lesion, and a Karnofsky performance status ≥70% were participated. After confirming the BMs, WBRT plus a radiation boost were done for all patients. The total dose of administered WBRT was 30Gy (given in 10 daily doses, each dose equal 3Gy/day). The booster radiation doses was given throughout 3D-CRT simultaneous integrated boost WBRT. The administered radiation dose was 3.5–5Gy/daily for 10 doses (Total 35–50Gy) varied according to the diameter of BMs . Results: The median period of follow-up was 14 months (range, 1 - 90 months). Median OS time was 13.5 months. The 6-, 12-, and 24-month OS intervals were reached 84.5, 62.7, and 21.5%, respectively. Higher Karnofsky performance status, solitary BMs, ≤2 cm maximum diameter of the largest BMs tumor, absence of progressive extracranial disease, asymptomatic BMs showed a statistically significant better overall survival in univariate analysis. In multivariate analysis, only, ≤2 cm maximum diameter of the largest BMs tumor, none progressive extracranial disease, and asymptomatic BMs were independently related to this end point. Conclusion: Additional radiation boost to whole brain radiation for treatment of small cell lung cancer metastases in brain appeared to offer beneficial effects on overall survival.