title: Whole brain irradiation and temozolomide based chemotherapy in melanoma brain metastases.
abstract: BACKGROUND
  Whole brain irradiation (WBRT) remains a recommended treatment for patients with brain metastases from malignant melanoma in terms of symptom palliation, especially when extracranial systemic disease is present. Temozolomide (TMZ) has shown efficacy in the treatment of metastatic melanoma. The objective was to evaluate the potential benefit in survival of two different schedules of total dose and fractionation (20 Gy/5 fractions vs 30 Gy/10 fractions) and further TMZ based chemotherapy.
  
  
  METHODS
  We have conducted a retrospective study in a group of twenty-one patients (RTOG Recursive Partitioning Analysis class II) of the use of WBRT with 20 Gy/5 fractions (n = 11) and 30 Gy/10 fractions (n = 10). All patients received further TMZ based chemotherapy administered as a single chemotherapeutic agent or in combination with chemo-immunotherapy.
  
  
  RESULTS
  Prognostic variables such as: age, Karnofsky performance status, extracranial metastases and number of brain metastases, were analyzed in both groups of treatment without statistically significant differences. The median survival time (MST) for WBRT 20 Gy group was 4 months (CI 95%: range 2- 6 months) and for WBRT 30 Gy group was 4 months (CI 95%: range 0-7 months) without statistically significant differences (Log rank p = 0.74). There was one complete response and two partial responses.
  
  
  CONCLUSIONS
  The results suggest that MST was not significantly affected by the total dose/fractionation schedule.
authors.affiliation: Department of Radiation Oncology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain. cconill@clinic.ub.es
authors.forename: Carlos
authors.initials: C
authors.lastname: Conill
authors.forename: Sandra
authors.initials: S
authors.lastname: Jorcano
authors.forename: Josep
authors.initials: J
authors.lastname: Domingo-Doménech
authors.forename: Rosa
authors.initials: R
authors.lastname: Gallego
authors.forename: Josep
authors.initials: J
authors.lastname: Malvehy
authors.forename: Susana
authors.initials: S
authors.lastname: Puig
authors.forename: Marcelo
authors.initials: M
authors.lastname: Sánchez
authors.forename: Ramón
authors.initials: R
authors.lastname: Vilella
authors.forename: Teresa
authors.initials: T
authors.lastname: Castel
mesh_terms: D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary*; D002945:Cisplatin / Q000008:administration & dosage; D015331:Cohort Studies; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage; D007376:Interleukin-2 / Q000008:administration & dosage; D015993:Life Tables; D008297:Male; D008545:Melanoma / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary*; D008875:Middle Aged; D018579:Patient Selection; D016016:Proportional Hazards Models; D011994:Recombinant Proteins; D012189:Retrospective Studies; D016019:Survival Analysis; D000077204:Temozolomide; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D018906:Antineoplastic Agents, Alkylating; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D007376:Interleukin-2; D011994:Recombinant Proteins; D014747:Vinblastine; D003606:Dacarbazine; D002945:Cisplatin; D000077204:Temozolomide