title: Results of hypofractionated whole brain radiotherapy (2×8 Gy) for patients with brain metastases from lung cancer.
abstract: OBJECTIVE
  To evaluate the clinical and radiologic response rates, toxicity and tolerability of 2×8 Gy whole brain radiotherapy (WBRT) in lung cancer patients with brain metastases (BM).
  
  
  METHODS
  WBRT was delivered to 126 lung cancer patients with BM during 2002-2006. External beam RT was delivered with a fraction dose of 8 Gy on the same day of each consecutive week. Tumor and symptom response and toxicity were recorded at every follow-up. Recursive partitioning analysis (RPA) and the new Graded Prognostic Assessment (GPA) were used for analysis of overall survival (OS).
  
  
  RESULTS
  Twenty-three patients had small cell (SCLC) and 103 had non small cell lung cancer. Pretreatment median Karnofsky performance score (KPS) was 70 (range 20-90). Clinical response rates were as follows: complete 31%; good partial 30.2%; partial 21.4%; stable 7.9%; and progressive 5.6%;. Median palliation and survival duration was 57 and 80 days, respectively. Two- and 6-month survival rates (SR) were 59.5% and 25.4%, respectively. According to recursive partitioning analysis (RPA) 6- month SR for groups 1, 2 and 3 were 61.5, 41.6 and 33.9%, respectively (p=0.002). Six-month SR for the new Graded Prognostic Assessment (GPA) were: GPA 0-1, 7%; GPA 1.5- 2.5, 34.2%; GPA 3, 25%; and GPA 3.5-4.0, 66.6% (p=0.0003).
  
  
  CONCLUSIONS
  2×8 Gy WBRT was found to be feasible. However, the late morbidity of this schedule is unknown so its use could be restricted to patients with poor performance status, with a short life expectancy and/or social problems, unlikely to tolerate more protracted radiotherapy regimens.
authors.affiliation: Ege University Medical School, Department of Radiation Oncology, Izmir, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Ozkok
authors.forename: Y
authors.initials: Y
authors.lastname: Bolukbasi
authors.forename: C
authors.initials: C
authors.lastname: Akay Akcay
authors.forename: D
authors.initials: D
authors.lastname: Yalman
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000532:radiotherapy*; D003037:Cobalt Radioisotopes / Q000627:therapeutic use*; D019583:Dose Fractionation, Radiation; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055752:Small Cell Lung Carcinoma / Q000473:pathology / Q000532:radiotherapy*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D003037:Cobalt Radioisotopes