title: Comparison of clinical outcomes of surgery followed by local brain radiotherapy and surgery followed by whole brain radiotherapy in patients with single brain metastasis: single-center retrospective analysis.
abstract: OBJECTIVE
  Data comparing the clinical outcomes of local brain radiotherapy (LBRT) and whole brain RT (WBRT) in patients with a single brain metastasis after tumor removal are limited.
  
  
  METHODS
  A retrospective analysis was performed to compare the patterns of treatment failure, cause of death, progression-free survival, median survival time, and Karnofsky performance status for long-term survivors among patients who underwent surgery followed by either LBRT or WBRT between 1990 and 2008 at the National Cancer Center Hospital.
  
  
  RESULTS
  A total of 130 consecutive patients were identified. The median progression-free survival period among the patients who received postoperative LBRT (n = 64) and WBRT (n = 66) was 9.7 and 11.5 months, respectively (p = .75). The local recurrence rates (LBRT, 9.4% vs. WBRT, 12.1%) and intracranial new metastasis rate (LBRT, 42.2% vs. WBRT, 33.3%) were similar in each arm. The incidence of leptomeningeal metastasis was also equivalent (LBRT, 9.4% vs. WBRT, 10.6%). The median survival time for the LBRT and WBRT patients was 13.9 and 16.7 months, respectively (p = .88). A neurologic cause of death was noted in 35.6% of the patients in the LBRT group and 36.7% of the WBRT group (p = .99). The Karnofsky performance status at 2 years was comparable between the two groups.
  
  
  CONCLUSIONS
  The clinical outcomes of LBRT and WBRT were similar. A prospective evaluation is warranted.
authors.affiliation: Division of Neurosurgery, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Narita
authors.forename: Yasuji
authors.initials: Y
authors.lastname: Miyakita
authors.forename: Makoto
authors.initials: M
authors.lastname: Ohno
authors.forename: Minako
authors.initials: M
authors.lastname: Sumi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mayahara
authors.forename: Takamasa
authors.initials: T
authors.lastname: Kayama
authors.forename: Soichiro
authors.initials: S
authors.lastname: Shibui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery*; D002423:Cause of Death; D003131:Combined Modality Therapy / Q000379:methods / Q000401:mortality; D016371:Cranial Irradiation / Q000379:methods*; D018572:Disease-Free Survival; D006801:Humans; D017567:Karnofsky Performance Status; D008577:Meningeal Neoplasms / Q000556:secondary; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D017741:Survivors; D016896:Treatment Outcome; D055815:Young Adult