Open AccessWhole‐brain radiotherapy plus sequential or simultaneous integrated boost for the treatment of a limited number of brain metastases in non‐small cell lung cancer: A single‐institution study
Author(s) -
Qing Dong,
Zhao Bin,
Zhou YiChen,
Zhu HongLei,
Ma DaiYuan
Publication year - 2020
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.2696
Subject(s) - medicine , whole brain radiotherapy , lung cancer , neurocognitive , radiation therapy , oncology , overall survival , brain metastasis , cancer , metastasis , cognition , psychiatry
Background To compare the survival outcomes and neurocognitive dysfunction in non‐small cell lung cancer (NSCLC) patients with brain metastases (BM ≤10) treated by whole‐brain radiotherapy (WBRT) with sequential integrated boost (SEB) or simultaneous integrated boost (SIB). Materials Fifty‐two NSCLC patients with a limited number of BMs were retrospectively analyzed. Twenty cases received WBRT+SEB (WBRT: 3 Gy*10 fractions and BMs: 4 Gy*3 fractions; SEB group), and 32 cases received WBRT+SIB (WBRT: 3 Gy*10 fractions and BMs: 4 Gy*10 fractions; SIB group). The survival and mini‐mental state examination (MMSE) scores were compared between the groups. Results The cumulative 1‐, 2‐, and 3‐year survival rates in the SEB vs SIB groups were 60.0% vs 47.8%, 41.1% vs 19.1%, and 27.4% vs 0%, respectively. The median survival times in the SEB and SIB groups were 15 and 10 months, respectively. The difference in survival rate was significant ( P = .046). Subgroup analysis revealed that 1‐, 2‐, and 3‐year survival rates and median survival time in the SEB group were significantly superior to those of the SIB group, especially for male patients (age <60 years) with 1‐2 BMs ( P < .05). The MMSE score of the SEB group at 3 months after radiation was higher than that of the SIB group ( P < .05). Nevertheless, WBRT+SEB required a longer treatment time and greater cost ( P < .005). Conclusions WBRT + SEB results in better survival outcomes than WBRT+SIB, especially for male patients (age <60 years) with 1‐2 BMs. WBRT+SEB also appeared to induce less neurocognitive impairment than WBRT+SIB.