Whole-brain radiotherapy combined with surgery or stereotactic radiotherapy in patients with brain oligometastases: long-term analysis.

Angelo Pompucci, Giuseppe Maria Di Lella, Alessio Albanese, Luigi Azario, Vincenzo Valentini, Mario Balducci, Giuseppe Roberto D'Agostino, Rosa Autorino, Maria Carmen De Santis, Stefania Manfrida, Giovanna Mantini, Vincenzo Frascino, Silvia Chiesa, Nicola Dinapoli, Alba Fiorentino, Carmelo Anile

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

OBJECTIVE: To verify whether the treatment of brain oligometastases with whole-brain radiotherapy (WBRT) plus stereotactic radiotherapy (SRT) or surgical resection results in different outcomes. METHODS: Files of patients affected by brain metastases submitted to surgical resection followed by WBRT (group A) or WBRT + SRT (group B) were retrospectively selected for this study. The two treatment groups were matched for the following potential prognostic factors: WBRT schedule, age, gender, performance status, tumor type, number of brain metastases, extra-cerebral metastases, and recursive partitioning analysis class (RPA). The outcomes of patients in both groups were evaluated in terms of toxicity, local control, and overall survival. RESULTS: Total of 97 patients were selected (56 male; 42 female) who were respectively submitted to surgical resection followed by WBRT (group A, n = 50 patients) or WBRT + SRT (Group B, n = 47 patients). Median follow-up was 95 months (range, 8-171 months). The 1-year local control rates were 46.0% and 69.0% respectively. No significant difference in local tumor control was observed between group A and B (p = 0.10). Median overall survival was 15 and 19 months in group A and B, respectively. One-year survival was 56.0% and 62%, respectively. No difference was observed in the two groups (p = 0.40). CONCLUSION: Surgery remains the main therapeutic approach in symptomatic patients; nevertheless, our data support the use of WBRT plus SRT in one or two brain metastases smaller than 3 cm.
Original languageEnglish
Pages (from-to)421-425
Number of pages5
JournalStrahlentherapie und Onkologie
Volume187
Publication statusPublished - 2011

Keywords

  • radiotherapy
  • surgery

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