Results of a randomized clinical trial comparing two radiation schedules in the palliative treatment of brain metastases

Haie-Méder, Christine; Pellae-Cosset, B.; Laplanche, Agnès; Lagrange, Jean‐Léon; Tuchais, C.; Noguès, Catherine; Arriagada, R.

doi:10.1016/0167-8140(93)90091-l

Cited by 108 publications

(32 citation statements)

References 18 publications

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“…Some studies also indicate that patients with brain metastases, with breast as the primary site, have a better chance of survival than those with lung as the primary [2,3,5,7,8,10,12]. In other studies, the primary site has not been a prognostic factor for survival [9,27]. In our own investigation, the primary site had no significant influence on survival.…”

Section: Discussionmentioning

confidence: 64%

“…Neurologic symptom-free survival might have been a better endpoint but could not sufficiently be evaluated retrospectively. The optimal dose fractionation schedules for patients with brain metastases have been evaluated in several randomized trials [3,9,10,17]. In general, patients treated over the shortest period of time and with larger fractions responded more quickly, but the duration of clinical response and time to progression were similar in various dose fractionation schedules.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Factors for Brain Metastases after Whole Brain Radiotherapy

et al. 2004

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Prognostic Factors for Brain Metastases after Whole Brain Radiotherapy

et al. 2004

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“…Two retrospective trials examined the outcomes of multiple treatments including WBRT, surgery, chemotherapy, or supportive care 42,43 . Twelve studies examined the use of various WBRT dose fractionation schedules 6,10,22,28,[44][45][46][47][48][49][50][51] , and seven trials assessed the efficacy of radiosensitizers and WBRT as compared with WBRT alone 9,21,24,25,[52][53][54] . Chemotherapy and WBRT were compared in eight studies 7,8,[55][56][57][58][59][60] .…”

Section: Multiple Brain Metastasesmentioning

confidence: 99%

“…A score is assigned based on assessment by an observer such as a physician, nurse, or researcher 27 . Trials often use a performance score to describe their study population or as a component of the study's exclusion criteria-for example, patients below a certain KPS score are deemed ineligible 28,29 .…”

Section: Introductionmentioning

confidence: 99%

Quality of Life in Brain Metastases Radiation Trials: A Literature Review

et al. 2008

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BackgroundAn estimated 20%-40% of cancer patients will develop brain metastases. Whole-brain radiotherapy (WBRT) is the standard treatment for patients with brain metastases. Although WBRT can reduce neurologic symptoms, the median survival following WBRT is between 3 and 6 months. Given this limited survival, it is important to consider quality of life (QOL) when treating patients with brain metastases. However, few studies have focused on QOL and improvement in patient-rated symptoms as primary outcomes. ObjectiveFor an accurate measurement of the extent to which previous trials have utilized QOL tools to evaluate the efficacy of WBRT for treatment of brain metastases, we undertook a literature review to examine the common endpoints and QOL instruments used. MethodsWe conducted a systematic search using the MEDLINE (1950( to December 2007 and Cochrane Central Register of Controlled Trials (4th quarter 2007) databases. Eligible studies investigated WBRT in one of the study arms. The following outcomes were included: median survival, overall survival, neurologic function, 1-year local control, and overall response; use of QOL instruments, performance status scales, and neurologic function assessments; and use of other assessment tools. Patient-rated QOL instruments were defined as those that strove to assess all dimensions of QOL; observerrated performance instruments such as the Karnofsky performance status (KPS) were deemed to be performance scales. ResultsWe identified sixty-one trials that included WBRT nine evaluated the treatment of a single brain metastasis, and fifty-two evaluated the treatment of multiple brain metastases. Although fifty-five of the trials employed a QOL instrument, few trials focused on QOL as an outcome. We found 23 different instruments used to evaluate QOL. The most commonly employed instrument was the KPS (n = 33), followed by various neurologic function classification scales (n = 21). A preponderance of the studies used 1 (n = 26, 43%) or 2 (n = 21, 34%) QOL instruments.A total of fourteen published trials on brain metastases included an evaluation of the study population's QOL. Those trials included three that used the Functional Assessment of Cancer Therapy-General scale and Brain subscale instrument, three that used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (C30) and the Brain Cancer Module 20 instrument, two that used study-designed QOL instruments, one that used the Edmonton Symptom Assessment Scale, two that used the Spitzer Quality of Life index, and three that used the KPS to evaluate QOL. Some trials reported deterioration in QOL after WBRT in patients with poorer prognosis; other trials detected an improvement in QOL after WBRT in patients with better prognosis. ConclusionsTo date, fourteen trials in brain metastases that have included an evaluation of the study population's QOL have been published. Although some studies showed that certain parameters of QOL deteriorate after WBRT, other studies showed that Q...

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“…Much focus, primarily through RTOG, was placed on comparing various dose-fractionation schedules of WBRT (Harwood and Simson 1977;Kurtz et al 1981;Borgelt et al 1980Borgelt et al , 1981Chatani et al 1986;Haie-Meder et al 1993;Murray et al 1997). Unfortunately, there was no survival benefit seen among the various tested regimens.…”

Section: Wbrtmentioning

confidence: 96%