Comparison of 20×2 Gy and 12×3 Gy for Whole-brain Irradiation of Multiple Brain Metastases from Malignant Melanoma.
OBJECTIVE
Most patients with multiple brain metastases from melanoma receive whole-brain irradiation. In a previous study, doses >30 Gy resulted in better outcomes than 10×3 Gy. However, the optimal dose-fractionation regimen has not yet been defined. This study compared 20×2 Gy over four weeks, which was used in the previous study, to 12×3 Gy over two-and-a-half weeks.


METHODS
Eleven patients treated with 20×2 Gy for multiple brain metastases were compared to 12 patients treated with 12×3 Gy.


RESULTS
Intracerebral control rates at 6 and 12 months were 17% and 0% after 20×2 Gy vs. 42% and 11% after 12×3 Gy (p=0.28). Survival rates at 6 and 12 months were 36% and 9% after 20×2 Gy vs. 50% and 25% after 12×3 Gy (p=0.75).


CONCLUSIONS
The less time-consuming regimen 12x3 Gy appeared not inferior to 20×2 Gy and a reasonable treatment option, particularly for patients with a limited life expectancy.
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany rades.dirk@gmx.net.
Dirk
D
Rades
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
Lena
L
Sehmisch
Department of Radiation Oncology, University Medical Center Epppendorf, Hamburg, Germany.
Amira
A
Bajrovic
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.|Medical Practice for Radiotherapy and Radiation Oncology, Hannover, Germany.
Stefan
S
Janssen
Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A.
Steven E
SE
Schild
D000368:Aged; D001921:Brain / Q000473:pathology / Q000528:radiation effects*; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000532:radiotherapy*; D008875:Middle Aged; D012878:Skin Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D013997:Time Factors
Melanoma; dose-fractionation regimens; intracerebral control; multiple brain metastases; survival; whole-brain irradiation