Whole-Brain Radiotherapy with 20 Gy in 5 Fractions for Brain Metastases in Patients with Cancer of Unknown Primary (CUP)

Abstract

Short-course WBRT with 5 x 4 Gy provided similar intracerebral control and survival as longer programs for the treatment of brain metastases in CUP patients. 5 x 4 Gy appears preferable because it is more convenient for patients.

A New Scoring System to Predicting the Survival of Patients Treated with Whole-Brain Radiotherapy for Brain Metastases

“…Brain metastases occur in 20-40% of all cancer patients and are more frequent than primary brain tumors [1,5,[8][9][10]. Whole-brain radiotherapy (WBRT) alone is the most common treatment for these patients resulting in a median survival of < 6 months in most series [11].…”

Comparison of stereotactic radiosurgery (SRS) alone and whole brain radiotherapy (WBRT) plus a stereotactic boost (WBRT + SRS) for one to three brain metastases

“…Brain metastases occur in 20-40% of all cancer patients and are more frequent than primary brain tumors [4,10,11,14]. The best available treatment of patients with one to three brain lesions still needs to be clarified.…”

Use of the Graded Prognostic Assessment (GPA) score in patients with brain metastases from primary tumours not represented in the diagnosis-specific GPA studies

“…Author Population Significant prognostic factors Sehouli et al [19] Ovarian cancer, n = 74 KPS, number of brain metastases, histological grade, platinum sensitivity (multivariate) Cohen et al [2] Ovarian cancer, n = 72 Aggressive local treatment Growdon et al [6] Gynaecological cancers, n = 30 Extracranial disease, histology, use of chemotherapy (multivariate) Fokas et al [4] Bladder cancer, n = 62 Extracranial metastases, RPA class Rades et al [15] Bladder cancer, n = 33 Multivariate analysis revealed no significant prognostic factors Tremont-Lukats et al [24] Prostate cancer, n = 103 Adenocarcinoma vs other histology Nonomura et al [12] Testicular germ cell tumours, n = 27 Single brain metastasis (multivariate) Salvati et al [18] Sarcoma, n = 35 KPS, complete en-bloc surgery Rades et al [13] Unknown primary, n = 101 KPS, extracranial metastases, RPA class Bartelt and Lutterbach [1] Unknown primary, n = 47 KPS, surgical resection status (multivariate) Ruda et al [16] Unknown primary, n = 33 Number of brain metastases (multivariate)…”