title: Results of whole brain radiotherapy and recursive partitioning analysis in patients with brain metastases from renal cell carcinoma: a retrospective study.
abstract: OBJECTIVE
  To determine the benefit of whole brain radiotherapy (WBRT) and the use of the Radiation Therapy Oncology Group (RTOG) recursive partitioning analysis (RPA) classification system in patients with brain metastases from renal cell carcinoma.
  
  
  METHODS
  We identified 46 consecutive patients with brain metastases from renal cell carcinoma who were treated with WBRT at the Cleveland Clinic Foundation between 1983 and 2000. We reviewed their charts for patient and tumor characteristics and categorized them according to the RTOG RPA classes.
  
  
  RESULTS
  The median follow-up and survival time for all 46 patients (15 women and 31 men) was 3.0 months. The median radiation dose was 3000 cGy in 10 fractions. Patients who received higher radiation doses (>3000 cGy) survived longer than those who received 3000 cGy or less than 3000 cGy (8.5 months vs. 2.7 months vs. 0.4 months, p = 0.0289). However, the Karnofsky performance status and RPA class were confounding factors in these data. The median survival for patients by RTOG RPA class was 8.5 months for Class I (n = 2), 3 months for Class II (n = 37), and 0.6 months for Class III (n = 7, p = 0.0834).
  
  
  CONCLUSIONS
  Despite the relatively poor prognosis of patients who receive WBRT alone, it appears that they benefit from this palliative treatment. The RTOG RPA classification system may be a useful tool in assessing prognosis in this patient population.
authors.affiliation: Department of Otolaryngology, Brain Tumor Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
authors.forename: Steven B
authors.initials: SB
authors.lastname: Cannady
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Cavanaugh
authors.forename: Shih-Yuan
authors.initials: SY
authors.lastname: Lee
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Bukowski
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Olencki
authors.forename: Glen H J
authors.initials: GH
authors.lastname: Stevens
authors.forename: Gene H
authors.initials: GH
authors.lastname: Barnett
authors.forename: John H
authors.initials: JH
authors.lastname: Suh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D002292:Carcinoma, Renal Cell / Q000532:radiotherapy* / Q000556:secondary*; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011879:Radiotherapy Dosage; D012189:Retrospective Studies