Clinical study on different doses and fractionated radiotherapies for multiple brain metastases of non-EGFR mutant lung adenocarcinoma

Abstract

Background: To study the effects and adverse reactions of different doses and fractionated radiotherapies on non-epidermal growth factor receptor (EGFR) mutant lung adenocarcinoma patients with multiple brain metastases.Methods: In total, 80 patients eligible for inclusion were randomly divided into 4 groups. Group A included whole brain radiotherapy (WBRT) alone 300 cGy/fraction ×10 fractions, at a total dose of 3,000 cGy.Group B included WBRT alone 180 cGy/fraction ×22 fractions, at a total dose of 3,960 cGy. Group C included intracranial metastases radiotherapy alone 250 cGy/fraction ×22 fractions at a total dose of 5,500 cGy.Group D included the whole brain + intracranial metastases group (SIB group) whole brain 180 cGy/fraction ×22 fractions intracranial metastases 250 cGy/fraction ×22 fractions, at a total dose 3,960 cGy, 5,500 cGy, respectively. Results:The median survival time of intracranial disease-free survival (IPFS) in group A, group B, group C, and group D was 6, 9, 8, and 13 months, respectively (P=0.000). The median overall survival (OS) time was 16, 24.5, 24, and 30 months, respectively (P=0.150). There was a significant difference in IPFS between different doses and fractionated radiotherapies, but there was no difference in OS. Multivariate analysis showed that the radiotherapy dose of intracranial metastases was positively correlated with IPFS and OS.

Real-world analysis of different intracranial radiation therapies in non-small cell lung cancer patients with 1–4 brain metastases

“…More studies supported the opinion that WBRT is associated with inferior quality of life and precognitive function. The incidence rates of memory decline in the groups of WBRT were significantly more increased than in the non-WBRT group [ 30 ]. In RTOG 0933 [ 31 ], a single-arm phase II study of WBRT without hippocampal avoidance (WBRT-HA), mean relative decline in Hopkins Verbal Learning Test–Revised Delayed Recall (HVLT-R DR) was magnificently lower(7.0% VS. 30%, 95% CI:4.7% to 18.7%, P < 0.001) in comparison with the historical control, a published phase III trial (PCI-P-120–9801).…”

Microbial metabolites affect tumor progression, immunity and therapy prediction by reshaping the tumor microenvironment (Review)

“…While a number of individuals have experienced positive outcomes from radiotherapy, it can nevertheless result in various negative effects. For instance, research has demonstrated that whole-brain radiotherapy administered to patients with lung cancer and brain metastases will ultimately result in memory impairment ( 100 ). A retrospective cohort study found that patients with nasopharyngeal carcinoma had a higher incidence of oral mucositis during radiotherapy ( 101 ).…”

Treatment of Alectinib in NSCLC With Brain Metastasis Patient Refractory to Radiotherapy After Resistance to Crizotinib: A Case Report and Literature Review

“…Because the patient had symptoms of high intracranial pressure and deterioration of dizziness, the patient and his family members refused biopsy. ALKr wasn s report [5], the patient was given the whole brain radiation therapy (WBRT) combined with simultaneous integrated boost (SIB) which aimed at metastatic focuses. WBRT was delivered in a course of 39.6 Gy in 22 fractions.…”