Whole-brain Radiotherapy With or Without a Simultaneous Integrated Boost for Treatment of Brain Metastases

Rades, Dirk; JOHANNWERNER, LEONIE; Werner, Elisa; CREMERS, FLORIAN; Gliemroth, Jan; YU, NATHAN Y.

doi:10.21873/anticanres.16482

Cited by 3 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…WBRT-SIB was reported to be well-tolerated with occasionally grade 3 toxicity (9)(10)(11)(12)(14)(15)(16)(17)(18)(19). A hippocampus-sparing technique has been developed over time because of signi cant neurocognitive decline following WBRT (24).…”

Section: Discussionmentioning

confidence: 99%

“…Recently, a few retrospective reports described good outcome in terms of local and intracranial control after WBRT+SRS or SEB, as well as after WBRT delivered with simultaneous integrated boost (SIB) [8][9][10][11][12][13][14][15][16][17][18][19]. In particular, survival bene ts have been observed in the WBRT-SIB groups compared to other boost delivery techniques combined to WBRT in patients with diffuse brain metastases.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcome of whole brain irradiation with a dose-escalated simultaneous-integrated boost in patients with multiple large and/or diffuse brain metastases: real live data and review of the literature

Agolli,

Nicosia,

Hilger

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: We retrospectively investigate feasibility and safety of whole brain radiotherapy (WBRT) including a simultaneous-integrated boost technique (WBRT-SIB) in a cohort of patients with a very poor prognosis suffering from multiple and/or large brain metastases, unfavorable primary histology, poor performance status and/or symptomatic BMs. Materials and Methods: Thirty-five patients with high brain tumor burden, extracranial metastases and low life-expectancy were treated with WBRT-SIB mostly with 35-42Gy/14 fractions. All metastases were boosted in patients with up to 12 BMs. Otherwise, in patients with >12 BMs besides large BMs, also small metastases located in critical regions of the brain were irradiated with a SIB. Results: The median number of BM was 8 (range 2-45) and the median BM diameter was 12 mm (range 4-90 mm). Fifteen (43%) patients had ≥10 BMs and 25 patients presented with a Karnofski index ≤ 80%. Primary tumor histology was NSCLC (n=13) and SCLC (n=11). The median iPFS was not reached, and 12- and 18-months iPFS were 75% and 50%, respectively. Overall, seven patients had intracranial progression: two patients within the SIB and WBRT area, one patient only within the SIB region and four patients had new BMs in the WBRT volume alone. The median iPFS for non-SCLC patients was 17 months and the 12- and 18-month iPFS were 56.8% and 28.4%, respectively. There was no significant OS difference between SCLC-group and non-SCLC patients (p=0.38). Overall, median OS was 8.7 months and 1-year OS was 25%. The treatment was generally well-tolerated with no observed cases of radionecrosis. Conclusion: Our WBRT-SIB approach involves a combination of whole brain radiotherapy and a simultaneous integrated boost to specific tumor volumes, and its effectiveness is compared with other treatment modalities in the literature. Further research, including prospective studies with larger patient cohorts, is necessary to validate and refine the findings.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outcome of whole brain irradiation with a dose-escalated simultaneous-integrated boost in patients with multiple large and/or diffuse brain metastases: real live data and review of the literature

Agolli,

Nicosia,

Hilger

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Efficacy and safety evaluation of combined therapies incorporating whole-brain radiotherapy in patients with brain metastases: a systematic review and meta-analysis

Yan,

Li,

Yang

et al. 2024

Clin Transl Oncol

View full text Add to dashboard Cite

Outcome of whole brain irradiation with a dose-escalated simultaneous-integrated boost in patients with multiple large and/or diffuse brain metastases: real live data and review of the literature

Agolli,

Nicosia,

Hilger

et al. 2024

Discov Onc

View full text Add to dashboard Cite

Background We retrospectively investigate feasibility and safety of whole brain radiotherapy (WBRT) including a simultaneous-integrated boost technique (WBRT-SIB) in a cohort of patients with a very poor prognosis suffering from multiple and/or large brain metastases, unfavorable primary histology, poor performance status and/or symptomatic BMs. Materials and Methods Thirty-five patients with high brain tumor burden, extracranial metastases and low life-expectancy were treated with WBRT-SIB mostly with 35-42 Gy/14 fractions. All metastases were boosted in patients with up to 12 BMs. In patients with > 12 BM, large and/or small metastases in critical brain regions were boosted up to a maximum of 12 SIB volumes. Results The median number of BM was 8 (range 2–45) and the median BM diameter was 12 mm (range 4–90 mm). Fifteen (43%) patients had ≥ 10 BMs and 25 patients presented with a Karnofski index ≤ 80%. Primary tumor histology was NSCLC (n = 13), SCLC (n = 11), breast cancer (n = 7), melanoma (n = 2), other (n = 2). The median iPFS was not reached, and 12- and 18-months iPFS were 75% and 50%, respectively. Overall, seven patients had intracranial progression: two patients within the SIB and WBRT area, one patient only within the SIB region and four patients had new BMs in the WBRT volume alone. The median iPFS for non-SCLC patients was 17 months and the 12- and 18-month iPFS were 56.8% and 28.4%, respectively. There was no significant OS difference between SCLC-group and non-SCLC patients (p = 0.38). Overall, median OS was 8.7 months and 1-year OS was 25%. The treatment was generally well-tolerated with no observed cases of radionecrosis. Conclusion Our WBRT-SIB approach involves a combination of whole brain radiotherapy and a simultaneous integrated boost to specific tumor volumes, and its effectiveness is compared with other treatment modalities in the literature. Further research, including prospective studies with larger patient cohorts, is necessary to validate and refine the findings.

show abstract

Whole-brain Radiotherapy With or Without a Simultaneous Integrated Boost for Treatment of Brain Metastases

Cited by 3 publications

References 0 publications

Outcome of whole brain irradiation with a dose-escalated simultaneous-integrated boost in patients with multiple large and/or diffuse brain metastases: real live data and review of the literature

Outcome of whole brain irradiation with a dose-escalated simultaneous-integrated boost in patients with multiple large and/or diffuse brain metastases: real live data and review of the literature

Efficacy and safety evaluation of combined therapies incorporating whole-brain radiotherapy in patients with brain metastases: a systematic review and meta-analysis

Outcome of whole brain irradiation with a dose-escalated simultaneous-integrated boost in patients with multiple large and/or diffuse brain metastases: real live data and review of the literature

Contact Info

Product

Resources

About