In a nutshell
The authors aimed to determine whether radiosurgery alone or in combination with whole-brain irradiation was the better treatment option for cerebral metastases (cancer that has spread to the brain).
Some background
Brain metastases occurs when cancer tumors have spread to the brain from another location in the body, like the lungs. Patients who have multiple brain tumors are usually treated with whole-brain irradiation (treatment that directs radiation into the brain to kill the cancer cells present). Patients who have very few brain tumors are typically treated with radiosurgery (one single dose of radiation directed at the brain tumors).
Methods & findings
The aim of this study was to determine whether radiosurgery alone or in combination with whole-brain irradiation was more successful in treating tumors in the brain resulting from lung cancer.
148 patients were used in this study. 98 patients received radiosurgery alone. 50 patients received combination treatment of both radiosurgery and whole-brain irradiation.
Using advanced testing it was determined that an ECOG score (scoring system used by doctors to monitor disease progression) of less than 1 (patient is fully active or restricted only in physically taxing activity) was significant in allowing improved control of the treated brain tumors. Patients who had a lower ECOG were 2.10 times more likely to achieve brain tumor control compared to patients with higher ECOG scores.
The number of brain tumors and treatment used were significant in determining the level of cancer control. Patients who had one brain tumor were 2.62 more likely to achieve brain tumor control. Patients who were treated with radiosurgery plus whole-brain irradiation were 4.67 more likely to achieve brain control as a result of combined treatment.
Patients with metastases of less than 18mm in diameter and patients with no extra-cerebral metastases (tumors have not spread to anywhere other than the brain) experienced an improved overall survival (time from treatment to death) Those with tumors of less than 18mm in diameter were 1.81 times more likely to survive than those who did not. Patients who had no extra-cerebral metastases were 2.98 times more likely to survive than those who did not. Patients who were treated in less than 12 months after diagnosis were also more likely to survive than those who were treated after 12 months.
The bottom line
The authors conclude that patients who received both radiosurgery and whole-brain irradiation and had very few cerebral metastases experienced improved brain control.
The fine print
More patients and longer follow-up times are required to apply this data to a larger population.
What’s next?
If you are considering radiation therapy as a treatment option for brain metastases, please consult your doctor for potential benefits and drawbacks.
Published By :
BMC cancer
Date :
Dec 15, 2014
