Background/Aim: Many patients with brain metastases receive whole-brain radiotherapy (WBRT). An important question is whether a delay between diagnosis of brain metastases and treatment impairs the patient's prognosis. Patients and Methods: This retrospective study investigated the impact of the interval between diagnosis of brain metastases and WBRT plus ten additional factors on overall survival (OS) in 573 patients. Prospective trials cannot be performed due to ethical concerns. Results: On univariate analyses, age (p<0.001), performance status (p<0.001), controlled primary tumor (p=0.047), metastases outside the brain (p<0.001) and completion of WBRT (p<0.001) were associated with OS. The interval between diagnosis and WBRT had no significant impact (p=0.84). On multivariate analysis, age (p=0.047), performance status (p<0.001), metastases outside the brain (p=0.029) and completion of WBRT (p<0.001) maintained significance. Conclusion: WBRT may be postponed for good reasons (multidisciplinary coordination of treatment, missing histology). OS was significantly associated with previously identified factors, which demonstrates consistency of the present data.Depending on the type of primary tumor, up to 30% of adult cancer patients develop brain metastases during the course of their malignant disease (1). The majority of these patients have already more than three metastases at their first presentation. This situation is often associated with a poor overall survival (OS). Therefore, whole-brain radiotherapy (WBRT) alone is the most common treatment for this patient group. For patients with a very limited number of brain metastases, WBRT may be combined with a local treatment such as neurosurgical resection or stereotactic radiosurgery (SRS)/fractionated stereotactic radiotherapy (FSRT) (2). In patients with very few intracerebral lesions and a low risk of developing new brain metastases outside the treated lesions, SRS may be delivered without WBRT (3). However, many patients with poor performance status or significant co-morbidities and a few brain metastases receive WBRT alone because they would not tolerate neurosurgery or SRS (4). Generally, it is considered important that WBRT is started as soon as possible, because brain metastases often cause significant symptoms such as headache, nausea/vomiting and neurologic deficits (5, 6). Several issues may cause a delay of up to two or three weeks between the diagnosis of brain metastases and the start of WBRT, e.g. presentation and discussion of the case in a multidisciplinary tumor board, waiting for a definitive histology, treatment planning, and sometimes even limited capacities of linear accelerators. An important question is whether such a delay has a negative impact on the patient's prognosis. This question has not yet been evaluated. Therefore, we investigated the potential impact of the interval between diagnosis of brain metastasis and start of WBRT on OS. In order to reduce the risk of a selection bias due to the WBRT regimen, only patients assigned to l...

Background/Aim: The interval between diagnostic imaging and whole-brain radiotherapy (WBRT) had no significant impact on survival in our previous study of WBRT for brain metastases. Since median survival time