Dose Escalation in Patients Receiving Whole-Brain Radiotherapy for Brain Metastases from Colorectal Cancer

Heisterkamp, Christine; Haatanen, Tiina; Schild, Steven E.; Rades, Dirk

doi:10.1007/s00066-010-2067-8

Cited by 23 publications

(22 citation statements)

References 30 publications

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“…Moreover, Jung and Kruser reported a similar relationship between the shorter interval of diagnosis and the better survival outcomes in patient with BM from CRC [8,9]. Similarly, the presence of concurrent extracranial metastases has also been reported to be significantly associated with poor prognosis after aggressive treatment for patients with BM from CRC [20][21][22]. However, in the present study, longer intervals and the presence of extracranial metastases were not negatively associated with survival in this study.…”

Section: Discussioncontrasting

confidence: 54%

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Brain metastases from colorectal carcinoma: a description of 60 cases in a single Chinese cancer center

et al. 2011

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The incidence of brain metastasis (BM) from colorectal carcinoma (CRC) is increasing. The objectives of the present study were to explore the clinical characteristics and potential prognostic factors in CRC patients with BM. Between April 1991 and December 2010, all CRC patients treated in the Sun Yat-sen University Cancer Center were retrospectively reviewed and 60 patients were identified to have BM (36 males and 24 females). The association between patients and their tumor characteristics, treatment modality, and survival were statistically analyzed. The median age at diagnosis of BM was 62.5 years. Fifty-three patients (88.3%) developed extracranial metastases at diagnosis of BM. The cause of death was systemic disease in 19 patients and neurological disease in 23 patients. Brain metastases were primarily treated with either whole brain radiation therapy (WBRT; 15 patients), stereotactic radiosurgery (SRS; nine patients), or surgical resection (seven patients). Ten patients received WBRT and SRS, and 19 patients (31.7%) were treated with steroids alone. The median survival after diagnosis of BM was 8 months (95% confidence interval = 4.2-11.8 months). Recursive partitioning analysis (RPA) class, the number of brain lesions, and treatment modality type were significantly associated with survival. Although BM from CRC is a late-stage phenomenon with an extremely poor prognosis, some subsets of patients would benefit from a multidisciplinary management strategy. A low RPA class and a limited number of brain lesions may predict increased survival after therapy for CRC patients with BM.

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Section: Discussioncontrasting

confidence: 54%

“…It has been suggested that a limited number of brain lesions is correlated with a favorable clinical outcome [10,18,20,28]. On the contrary, Kruser and colleagues [9] found that the presence of more than three brain metastases was a positive prognostic factor.…”

Section: Discussionmentioning

confidence: 95%

Brain metastases from colorectal carcinoma: a description of 60 cases in a single Chinese cancer center

et al. 2011

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“…In agreement with the reports of other authors, in the treatment of our group of patients with HM to the brain, surgery, stereotactic radiotherapy, WBPR, and WBRT were used [14,15,18,22,26,32,33,36,38,43,46,49,50]. The median survival of 10 patients was 4 months (range, 1-68 months); 2 patients treated with surgical resection and WBRT survived 60 months.…”

Section: Hm To the Brainsupporting

confidence: 74%

Hematogenous metastases in patients with Stage I or II endometrial carcinoma

et al. 2011

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Hormonal therapy and chemotherapy play a major role in the palliative management of patients with hematogenous metastases from endometrial carcinoma to the liver, lungs, and bones. Radical treatment in patients with metastases to the lung or liver consists of resection of the metastasis combined with chemo- and/or hormonotherapy for metastases to the bones treatment consists of radiotherapy + chemotherapy, for metastasis to the brain treatment consists of resection combined with radiotherapy.

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“…Simultaneous brain metastases are diagnosed in half of the patients [16]. However, the prognosis is determined by LMC, since survival after brain metastases exceeds that of LMC by several fold [9,14,20] Current treatment recommendations predominately based on retrospective series comprise chemotherapy, radiotherapy, or both modalities. Chemotherapy is given intravenously (i.v.)…”

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confidence: 99%

Outcome after whole brain radiotherapy alone in intracranial leptomeningeal carcinomatosis from solid tumors

et al. 2012

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Dose Escalation in Patients Receiving Whole-Brain Radiotherapy for Brain Metastases from Colorectal Cancer

Abstract: These data suggest that patients with brain metastases from colorectal cancer treated with WBRT alone appeared to benefit from escalation of the radiation dose beyond 10 x 3 Gy in terms of improved OS and LC.

Cited by 23 publications

References 30 publications

Brain metastases from colorectal carcinoma: a description of 60 cases in a single Chinese cancer center

Brain metastases from colorectal carcinoma: a description of 60 cases in a single Chinese cancer center

Hematogenous metastases in patients with Stage I or II endometrial carcinoma

Outcome after whole brain radiotherapy alone in intracranial leptomeningeal carcinomatosis from solid tumors

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