Therapeutic effects of 20 gray radiotherapy over a week in the management of brain metastases.
OBJECTIVE
To determine the therapeutic effects of 20 Gy over a week in the management of multiple brain metastases. Secondly to determine the toxicity profile and survival at 6th month in patients treated with the above-mentioned protocol.


METHODS
This was a single arm interventional study, conducted at Nuclear Medicine, Oncology and Radiotherapy Institute (NORI), Islamabad from May 8, 2006 to May 31, 2007. Thirty patients with multiple brain metastases were inducted in this study. Mean age was 52 +/- 11 years. Fifty Four percent were females and 46% males. After initial workup, all were planned for whole brain radiotherapy. 20 Gy was given to whole brain by two parallel opposed, equally weighted lateral fields in five consecutive daily fractions. Dose per fraction was four Gy. All were followed up for six months for survival. Treatment response was categorized in four different categories i.e., > 50%, approximately 50%, < 50% and no response.


RESULTS
It revealed that there was significant effect of treatment with 20 Gy radiotherapy as 76% of the patients during and 80% on the last day of therapy showed > 50% response (p < 0.05). Secondly, median survival of the patients after radiotherapy was two months (p < 0.05). No serious toxicity was noted during this therapy.


CONCLUSIONS
Twenty Gy over a week is highly effective in palliation of symptoms due to multiple brain metastases. In comparison with other studies, this protocol had no significant difference in overall survival and acute toxicity.
Asghar
Asghar Hussain
AH
Nuclear Medicine, Oncology and Radiotherapy Institute (NORI), G-8/3, Islamabad, Pakistan.
Mahmood
Humera
H
Faheem
Mohammad
M
Rizvi
Sadia
S
Sajid
Abida
A
Irfan
Javaid
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000556:secondary; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology; D016371:Cranial Irradiation; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008175:Lung Neoplasms / Q000473:pathology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D013534:Survival; D016896:Treatment Outcome