Browse > Article
http://dx.doi.org/10.14316/pmp.2015.26.3.137

Outcomes after Reirradiation for Brain Metastases  

Yu, Jesang (Department of Radiation Oncology, Kosin University Gospel Hospital, Kosin University College of Medicine)
Choi, Ji Hoon (Department of Radiation Oncology, Kosin University Gospel Hospital, Kosin University College of Medicine)
Ma, Sun Young (Department of Radiation Oncology, Kosin University Gospel Hospital, Kosin University College of Medicine)
Jeung, Taesig (Department of Radiation Oncology, Kosin University Gospel Hospital, Kosin University College of Medicine)
Publication Information
Progress in Medical Physics / v.26, no.3, 2015 , pp. 137-142 More about this Journal
Abstract
We retrospectively analyzed the outcomes in patients who underwent reirradiation for brain metastasis. Twenty-three patients with brain metastases who were initially treated with palliative brain radiotherapy and were retreated with a second course of brain RT between June 2008 and December 2012. WBRT, 3DCRT and SRS were used for brain metastasis. The median dose of the first course of WBRT was 30 Gy (range, 23.4~30 Gy). The dose of the first course 3DCRT for lesion was 30 Gy in 3 Gy per fraction. The median dose of the first course of SRS was 16 Gy in 1 fraction (range, 12~24 Gy). The median dose of the second course of WBRT was 27.5 (range, 12~30 Gy). The median dose of the second course of 3DCRT for lesion was 30 Gy (range, 25~30 Gy). The dose of the second course of SRS was 16 Gy in 1 fraction. The second course of WBRT was administered on radiographic disease progression with symptom in all patients. With median follow-up of 25 months, overall symptom resolution rates were 47.8%. Rate of palliative efficacy was 82.6% including stable disease. The median survival time after initiation of reirradiation was 3.2 months. Median value of KPS prior to reirradiation was 30. Median value of KPS after reirradiation was 60. Reirradiation of brain metastasis maybe feasible and effective in select patients with a good performance status $KPS{\geq}60$ (: ECOG 0~2) prior to reirradiation.
Keywords
Brain metastasis; Reirradiation; Performance status; KPS;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Nussbaum ES, Djalilian HR, Cho KH, Hall WA. Brain Metastases Histology, Multiplicity, Surgery, and Survival. Cancer 1996;78:1781-8.   DOI
2 Barani IJ, Larson DA, Berger MS. Future directions in treatment of brain metastases. Surg Neurol Int 2013;4:220-31.   DOI
3 Gravrilovic IT, Posner JB. Brain metastases: epidemiology and pathophysiology. J Neuro Oncol 2005;75:5-14.   DOI
4 Neider C, Spanne O, Mehta MP, Grosu AL, Geinitz H. Presentation, patterns of care, and survival in patients with brain metastases. Cancer 2011;117:2505-12.   DOI
5 Wong J, Hird A, Zhang L, et al. Symptoms and quality of life in cancer patients with brain metastases following palliative radiotherapy. Int J Radiat Oncol Biol Phys 2009;75:1125-31.   DOI
6 Minniti G, Scaringi C, Lanzetta G, et al. Whole brain reirradiation and concurrent temozolomide in patients with brain metastases. J Neurooncol 2014;118:329-34.   DOI
7 Ozgen Z, Atasoy BM, Kefeli AU, et al. The benefit of whole brain reirradiation in patients with multiple brain metastases. Radiat Oncol 2013;8:186.   DOI
8 Wong WW, Schild SE, Sawyer TE, Shaw EG. Analysis of outcome in patients reirradiated for brain metastases. Int J Radiat Oncol Biol Phys 1996;34:585-90.   DOI
9 Lucas JT, Colmer HG, White L, et al. Competing risk analysis of neurologic versus nonneurologic death in patients undergoing radiosurgical salvage after whole-brain radiation therapy failure: who actually dies of their brain metastases. Int J Radiat Oncol Biol Phys 2015;92:1008-15.   DOI
10 Yuan H, Gaber MW, Boyd K, et al. Effect of fractionated radiation on the brain vasculature in a murine model: bloodbrain barrier permeability, astrocyte proliferation, and ultrastructural changes. Int J Radiat Oncol Biol Phys 2006;66:860-6.   DOI
11 Mayer R. Sminia P. Reirradiation tolerance of the human brain. Int J Radiat Oncol Biol Phys 2008;70:1350-60.   DOI
12 Son CH, Jimenez R, Niemierko A, et al. Outcome after whole brain reirradiation in patients with brain metastases. Int J Radiat Oncol Biol Phys 2012;82:e167-72.   DOI
13 Adkison JB, Tome W, Seo S, et al. Reirradiation of largevolume recurrent glioma with pulsed reduced-dose-rate radiotherapy. Int J Radiat Oncol Biol Phys 2011;79:835-41.   DOI
14 Maranzano E, Trippa F, Casale M, et al. Reirradiation of brain metastases with radiosurgery. Radiother Oncol 2012;102: 192-7.   DOI
15 Veninga T, Langendijk HA, Slotman BJ, et al. Reirradiation of primary brain tumours: survival, clinical response and prognostic factors. Radiother Oncol 2011;59:127-37.
16 Olson AC, Wegner RE, Rwigema JCM, et al. Clinical outcomes of reirradiation of brain metastases from small cell lung cancer with Cyberknife stereotactic radiosurgery. J Cancer Res and Ther 2012;8:411-6.   DOI
17 Paulino AC, Mai WY, Chintagumpala M, Taher A, The BS. Radiation-induced malignant gliomas: is there a role for reirradiation? Int J Radiat Oncol Biol Phys 2008;71:1381-7.   DOI
18 Shaw E, Scott C, Souhami L, et al. Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: Final report of RTOG protocol 90-05. Int J Radiat Oncol Biol Phys 2000;47:291-8.   DOI
19 E, Bezjak A, Yi QL, et al. Value of whole brain re-irradiation for brain metastases - single centre experience. Clin Oncol 2007;19:532-8.   DOI
20 Emami B, Lyman J, Brown A, et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 1991;21:109-22.
21 Lawrence YR, Li XA, el Naqa I, et al. Radiation dose-volume effects in the brain. Int J Radiat Oncol Biol Phys 2010; 76(3Suppl):S20-7.   DOI